US20140005693A1 - Interchangeable clip applier - Google Patents
Interchangeable clip applier Download PDFInfo
- Publication number
- US20140005693A1 US20140005693A1 US13/536,374 US201213536374A US2014005693A1 US 20140005693 A1 US20140005693 A1 US 20140005693A1 US 201213536374 A US201213536374 A US 201213536374A US 2014005693 A1 US2014005693 A1 US 2014005693A1
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- United States
- Prior art keywords
- firing
- actuator
- clip
- shaft
- drive
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00464—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
Definitions
- a variety of fasteners can be utilized to treat, clamp, fasten, secure, and/or hold tissue.
- Clips can be positioned relative to tissue located within a surgical site in a patient and then deformed to apply a clamping force, for example, to the tissue.
- FIG. 1 is a partial perspective view of a clip applier
- FIG. 2 is a cross-sectional view of an end effector of the clip applier of FIG. 1 comprising a removable clip cartridge, a reciprocating firing drive for sequentially advancing the clips, a receiver for receiving the clips, and a crimping drive for deforming the clips;
- FIG. 3 is a partial cross-sectional view of the clip applier of FIG. 1 in an open configuration
- FIG. 4 is a partial cross-sectional view of the clip applier of FIG. 1 in a closed configuration
- FIG. 5 is a cross-sectional view of the end effector of FIG. 2 in an unfired condition
- FIG. 6 is a cross-sectional view of the end effector of FIG. 2 illustrating the firing drive in a partially fired condition in which a firing member of the firing drive has advanced a clip into the receiver;
- FIG. 7 is a cross-sectional view of the end effector of FIG. 2 illustrating the firing drive coming into engagement with the crimping drive;
- FIG. 8 is a cross-sectional view of the end effector of FIG. 2 illustrating the crimping drive in an at least partially fired condition
- FIG. 9 is a cross-sectional view of the end effector of FIG. 2 illustrating the firing drive becoming disengaged from the firing member;
- FIG. 10 is a cross-sectional view of the end effector of FIG. 2 illustrating the crimping drive in its fully fired condition
- FIG. 11 is a cross-sectional view of the firing drive of the end effector of FIG. 2 in a partially retracted position in which the firing drive is being re-engaged with the firing member;
- FIG. 12 is a cross-sectional view of the firing drive of the end effector of FIG. 2 being disengaged from the crimping drive;
- FIG. 13 is a perspective view of a clip illustrated in FIGS. 2-12 ;
- FIG. 14 is a front view of a cartridge illustrated in FIGS. 1-12 comprising a plurality of clips with portions of the cartridge removed to illustrate the clips stored in the cartridge;
- FIG. 15 is a side view of the cartridge of FIG. 14 illustrated with portions removed to illustrate the clips stored in the cartridge;
- FIG. 16 is a cross-sectional plan view of the cartridge of FIG. 14 taken along line 16 - 16 in FIG. 15 ;
- FIG. 17 is a side view of an alternative cartridge usable in connection with the clip applier of FIGS. 1-12 or any other suitable clip applier, wherein the cartridge is illustrated with portions removed to illustrate a biasing member and a pusher plate positioned intermediate the biasing member and the clips contained therein;
- FIG. 18 is a side view of a cartridge in accordance with at least one alternative embodiment illustrated with portions removed to illustrate a biasing member and a lockout plate positioned intermediate the biasing member and the clips contained therein;
- FIG. 19 is a cross-sectional plan view of the cartridge of FIG. 18 taken along line 19 - 19 in FIG. 18 ;
- FIG. 20 is a side view of a further alternative cartridge usable in connection with the clip applier of FIGS. 1-12 or any other suitable clip applier, wherein the cartridge can comprise a housing illustrated with portions removed to illustrate a lockout plate comprising guides which are configured to co-operate with guides defined in the cartridge housing;
- FIG. 21 is a cross-sectional plan view of the cartridge of FIG. 20 taken along line 21 - 21 in FIG. 20 ;
- FIG. 22 is an elevational view of a firing drive comprising a rotary input, a rotary output, a firing nut engaged with the rotary output, and a transmission in a firing configuration in accordance with at least one embodiment;
- FIG. 23 is a perspective view of the firing drive of FIG. 22 illustrating the firing nut in an unfired position
- FIG. 24 is a perspective view of the firing drive of FIG. 22 illustrating the firing nut advanced along the rotary output and a cam extending from the firing nut;
- FIG. 25 is a perspective view of the firing drive of FIG. 22 illustrating the cam of the firing nut engaged with the transmission of the firing drive and the transmission in a reverse configuration;
- FIG. 26 is a perspective view of the firing drive of FIG. 22 illustrating firing nut in a retracted position and a second cam extending from the firing nut engaged with the transmission to shift the transmission from its reverse configuration to its firing configuration;
- FIG. 27 is a perspective view of a robotic surgical instrument system operably supporting a plurality of surgical tools usable with the clip applier of FIGS. 2-12 or any other suitable clip applier;
- FIG. 28 is a perspective view of a surgical tool including an actuator module, a shaft extending from the actuator module, and a replaceable end effector;
- FIG. 29 is a perspective view of a handle actuator usable with the clip applier of FIGS. 2-12 or any other suitable clip applier;
- FIG. 30 is a cross-sectional view of the articulation joint illustrated in FIG. 2 ;
- FIG. 31 is a rear perspective view of an alternative actuator module that may be used in place of the actuator module of FIG. 28 with at least a portion of its housing removed;
- FIG. 32 is an exploded view of a portion of the actuator module of FIG. 31 ;
- FIG. 33 is a partial sectional view of the actuator module of FIG. 31 ;
- FIG. 34 is a cross-sectional view of an articulation actuator of the actuator module of FIG. 31 .
- a surgical instrument such as a clip applier 100
- a surgical instrument can be configured to apply one or more clips to tissue located within a surgical site in the patient.
- the clip applier 100 can be structured and arranged to position a clip 140 relative to the tissue in order to compress the tissue within the clip 140 .
- the clip applier 100 can be configured to deform the clip 140 as illustrated in FIGS. 3 and 4 , for example, and as described in greater detail further below.
- Each clip 140 can comprise a base 142 and opposing legs 144 extending from the base 142 .
- the base 142 and the legs 144 can comprise any suitable shape and can define a substantially U-shaped configuration and/or a substantially V-shaped configuration, for example.
- the base 142 can comprise angled portions 141 which are connected together by a joint 143 .
- the legs 144 of the clip 140 can be positioned on opposite sides of the tissue wherein the legs 144 can be pushed toward one another to compress the tissue positioned between the legs 144 .
- the joint 143 can be configured to permit the angled portions 141 of the base 142 , and the legs 144 extending therefrom, to deform inwardly.
- the clip 140 can be configured to yield, or deform plastically, when the clip 140 is sufficiently compressed, although some amount of elastic deformation, or spring-back, may occur within the deformed clip 140 .
- the clip applier 100 can include a shaft 110 , an end effector 120 , and a replaceable clip cartridge, or magazine, 130 .
- the clip cartridge 130 can comprise a housing 132 and a plurality of clips 140 positioned within the housing 132 .
- the housing 132 can define a storage chamber 134 in which the clips 140 can be stacked.
- the storage chamber 134 can comprise sidewalls which extend around, or at least substantially around, the perimeter of the clips 140 .
- each clip 140 can comprise opposing faces, such as a top face 145 and a bottom face 146 on opposite sides of the clip 140 wherein, when the clips 140 are stacked in the housing 132 , the top face 145 of a clip 140 can be positioned against the bottom face 146 of an adjacent clip 140 and wherein the bottom face 146 of the clip 140 can be positioned against the top face 145 of another adjacent clip 140 .
- the bottom faces 146 of the clips 140 can face downwardly toward one or more support shelves, or platforms, 135 defined in the housing 132 while the top faces 145 of the clips 140 can face upwardly away from the support shelves 135 .
- the top faces 145 and the bottom faces 146 of the clips 140 may be identical, or at least substantially identical, in some cases, while, in other cases, the top faces 145 and the bottom faces 146 may be different.
- the stack of clips 140 depicted in FIGS. 14-16 comprises five clips 140 , for example; however, other embodiments are envisioned in which the stack of clips 140 can include more than five clips 140 or less than five clips 140 .
- the clip cartridge 130 can further comprise at least one biasing member, such as biasing member 136 , for example, positioned intermediate the housing 132 and the top clip 140 in the stack of clips 140 .
- the biasing member 136 can be configured to bias the bottom clip 140 in the stack of clips 140 or, more particularly, the bottom face 146 of the bottom clip 140 , against the support shelves 135 defined in the housing 132 .
- the biasing member 136 can comprise a spring, and/or any suitable compressed elastic element, for example, which can be configured to apply a biasing force to the clips 140 , or at least apply a biasing force to the top clip 140 which is transmitted downwardly through the stack of clips 140 .
- the clip 140 When a clip 140 is positioned against the support shelves 135 as described above, the clip 140 can be supported in a firing position in which the clip 140 can be advanced and ejected from the cartridge 130 .
- the support shelves 135 can define at least a portion of a firing chamber 149 in which the clips 140 can be sequentially positioned in the firing position.
- the firing chamber 149 can be entirely defined within the cartridge 130 or, in other cases, the firing chamber 149 can be defined within and/or between the shaft 110 and the cartridge 130 .
- the clip applier 100 can comprise a firing drive which can advance a firing member into the cartridge 130 and push the clip 140 from its firing position positioned against the support shelves 135 to a fired position in which it is received within the end effector 120 of the clip applier 100 .
- the housing 132 of the cartridge 130 can comprise a proximal opening, or window, 133 which can be aligned, or at least substantially aligned, with the support shelves 135 such that the firing member can enter into the cartridge 130 through the proximal opening 133 and advance a clip 140 distally out of the cartridge 130 .
- the housing 132 can further comprise a distal, or discharge, opening, or window, 137 which is also aligned with the support shelves 135 such that the clip 140 can be advanced, or fired, distally along a firing axis 139 extending through the proximal opening 133 , the firing chamber 149 , and the distal opening 137 , for example.
- the firing member of the firing drive can be advanced into to the cartridge housing 132 and, in various circumstances, into the firing chamber 149 .
- the firing member can pass entirely through the cartridge 130 in order to advance the clip 140 into its fired position within the end effector 120 .
- the firing member can be retracted sufficiently such that the biasing member 136 can position another clip 140 against the support shelves 135 .
- the biasing member 136 can bias a clip 140 against the firing member while the firing member is positioned within the housing 132 .
- Such a clip 140 can be referred to as a queued clip.
- the biasing member 136 can then bias the clip 140 against the support shelves 135 where it is staged for the next stroke of the reciprocating firing member.
- the cartridge 130 can be configured to supply the clips 140 to the firing chamber 149 along a predetermined path, such as supply axis 138 , for example.
- the supply axis 138 can be transverse to the firing axis 139 such that the clips 140 are fed into the firing chamber 149 in a direction which is different than the direction in which the firing member passes through the firing chamber 149 .
- the supply axis 138 can be perpendicular, or at least substantially perpendicular, to the firing axis 139 , for example.
- the shaft 110 can comprise a cartridge, or magazine, aperture 131 which can be sized and configured to receive a clip cartridge 130 , for example, therein.
- the cartridge aperture 131 can be sized and configured such that the housing 132 of the cartridge 130 is closely received within the cartridge aperture 131 .
- the sidewalls which define the cartridge aperture 131 can limit, or at least substantially limit, the lateral movement of the cartridge 130 relative to the shaft 110 .
- the shaft 110 and/or the cartridge 130 can further comprise one or more locks which can be configured to releasably hold the cartridge 130 in the cartridge aperture 131 . As illustrated in FIG.
- the cartridge 130 can be loaded into the cartridge aperture 131 along an axis which is, in at least one embodiment, parallel to or collinear with the supply axis 138 .
- the shaft 110 can further comprise a pad or seat 118 extending from the sidewall 111 of the shaft 110 wherein the pad 118 can be configured to be received within and/or engaged with the housing 132 of the cartridge 130 .
- the pad 118 can be sized and configured to be closely received within a recess 148 defined in the cartridge housing such that the pad 118 can limit, or at least substantially limit, the lateral movement of the cartridge 130 relative to the shaft 110 .
- the pad 118 can be sized and configured to align the cartridge 130 within the shaft 110 and/or support the cartridge housing 132 .
- a firing drive 160 of the clip applier 100 can be actuated to advance the clips 140 from the clip cartridge 130 as described above.
- the firing drive 160 can comprise a rotary drive input such as a drive screw 161 , for example, and a displaceable firing nut 163 operably engaged with the drive screw 161 .
- the drive screw 161 can comprise at least one drive thread 162 which can be threadably engaged with a threaded aperture extending through the firing nut 163 .
- the clip applier 100 can further include an electric motor, for example, operably coupled with the drive screw 161 .
- the drive screw 161 can be operably coupled with the motor of a surgical instrument system comprising a hand-held instrument or a robotic arm, for example.
- the movement of the firing nut 163 within the shaft 110 can be constrained such that the firing nut 163 moves along a longitudinal axis 164 when the drive screw 161 is rotated about the longitudinal axis 164 by the motor.
- the drive screw 161 can advance the firing nut 163 distally toward the end effector 120 , as illustrated in FIG. 6 .
- the shaft 110 can comprise one or more bearings which can be configured to rotatably support the drive screw 161 .
- a bearing 159 can be configured to rotatably support the distal end of the drive screw 161 , for example, as illustrated in FIGS. 5 and 6 .
- the firing drive 160 can further comprise a firing member 165 extending from the firing nut 163 which can be advanced distally and retracted proximally with the firing nut 163 , as described in greater detail further below.
- a firing member 165 extending from the firing nut 163 which can be advanced distally and retracted proximally with the firing nut 163 , as described in greater detail further below.
- the clip cartridge 130 is illustrated as comprising a plurality of clips 140 stored therein wherein one of the clips 140 is positioned in a firing position, as described above.
- the firing member 165 can include a distal portion 166 which can be advanced into the staple cartridge 130 along a firing axis 167 and engage the clip 140 positioned in the firing position when the firing member 165 and the firing nut 163 are advanced distally.
- the firing member 165 can comprise a linear member while, in other cases, the distal end 166 of the firing member 165 can extend upwardly from the firing member 165 , for example.
- the firing member 165 can advance the clip 140 distally out of the clip cartridge 130 along the firing axis 167 and into a receiving cavity 122 defined in the end effector 120 .
- the firing member 165 can be attached to and extend distally from the firing nut 163 while, in other cases, the firing member 165 and the firing nut 163 can be operably connected to one another by a firing actuator 168 .
- the firing actuator 168 can be pivotably mounted to the firing member 165 at a pivot 169 and can include a distal arm 170 a and a proximal arm 170 b which can be engaged with a longitudinal slot 113 defined in the housing 112 of the shaft 110 .
- each of the arms 170 a , 170 b can include a projection, such as projections 171 a and 171 b , respectively, extending therefrom which can be configured to slide within the longitudinal slot 113 .
- the firing nut 163 can further include a firing pin 172 extending therefrom which can be configured to engage the distal arm 170 a in order to advance the actuator 168 and the firing member 165 distally, as described above.
- the firing nut 163 can be advanced distally by the drive screw 161 wherein the firing pin 172 , which is positioned intermediate the distal arm 170 a and the proximal arm 170 b , can contact the distal arm 170 a and drive the actuator 168 and the firing member 165 distally.
- the actuator 168 may be prevented from rotating about the pivot pin 169 as one or both of the projections 171 a and 171 b sliding in the shaft slot 113 can be prevented from being moved laterally relative to the longitudinal shaft slot 113 until the actuator 168 reaches the position illustrated in FIG. 6 .
- the distal projection 171 a can enter into a distal slot portion 114 of the longitudinal slot 113 which can be configured to pivot the actuator 168 downwardly, or permit the actuator 168 to be pivoted downwardly, as illustrated in FIG. 9 .
- the distal projection 171 a can come into contact with the sidewall of the distal slot portion 114 which can guide the distal projection 171 a downwardly and pivot the actuator 168 about the pivot 169 as the actuator 168 is advanced forward by the firing nut 163 .
- the firing pin 172 extending from the firing nut 163 may no longer be engaged with the distal arm 170 a of the actuator 168 wherein, subsequently, the firing nut 163 may move distally independently of the actuator 168 thereby leaving behind the actuator 168 and the firing member 165 .
- the distal end 114 of the longitudinal shaft slot 113 may deactivate the firing member 165 wherein, at such point, the position of the firing member 165 may represent the fully-fired or distal-most position of the firing member 165 .
- the clip 140 has been fully advanced into the receiving cavity, or receiver, 122 .
- the next clip 140 to be advanced into the receiving cavity 122 may be biased against the top surface of the firing member 165 , further to the above.
- the end effector 120 of the clip applier 100 can further comprise a first jaw 123 a and a second jaw 123 b wherein the first jaw 123 a and the second jaw 123 b can at least partially define the receiving chamber 122 .
- the first jaw 123 a can comprise a first channel 124 a and the second jaw 123 b can comprise a second channel 124 b which can each be configured to receive and support at least a portion of a clip 140 therein.
- the first jaw 123 a can be pivotably coupled to a frame 111 of the shaft 110 by a pin 125 a and the second jaw 123 b can be pivotably coupled to the frame 111 by a pin 125 b .
- the crimping drive 180 can be configured to rotate the first jaw 123 a toward the second jaw 123 b and/or rotate the second jaw 123 b toward the first jaw 123 a in order to compress the clip 140 positioned therebetween.
- the crimping drive 180 can comprise a cam actuator 181 which can be configured to engage a first cam surface 126 a defined on the first jaw 123 a and a second cam surface 126 b on the second jaw 123 b in order to pivot the first jaw 123 a and the second jaw 123 b toward one another.
- the cam actuator 181 can comprise a collar which at least partially surrounds the first jaw 123 a and the second jaw 123 b .
- the collar can comprise an inner cam surface 182 which can be contoured to contact the cam surfaces 126 a , 126 b of the jaws 123 a , 123 b and drive them inwardly toward one another.
- the clip 140 positioned within the receiving chamber 122 defined in the end effector 120 can be positioned relative to tissue before the crimping drive 180 is actuated.
- the crimping drive 180 can be at least partially actuated prior to positioning the clip 140 relative to the tissue in order to at least partially compress the clip 140 .
- the clip 140 and the receiving chamber 122 can be sized and configured such that the clip 140 can be biased or flexed inwardly when the end effector 120 is in its unactuated state, as illustrated in FIG. 3 .
- the crimping first jaw 123 a and the second jaw 123 b can be actuated to elastically crimp and/or permanently crimp the clip 140 positioned therebetween.
- the firing nut 163 can be configured to actuate the crimping drive 180 .
- the crimping drive 180 can comprise a crimping actuator 188 operably coupled with the cam actuator 181 wherein the crimping actuator 188 can be selectively engaged by the firing nut 163 as the firing nut 163 is advanced distally as described above.
- the firing nut 163 can further comprise a second firing pin, such as firing pin 184 , for example, extending therefrom which can be configured to engage the crimping actuator 188 as the firing nut 163 is advancing the firing actuator 168 .
- the crimping actuator 188 is positioned in an unactuated position and, when the firing nut 163 is advanced sufficiently to engage a distal arm 190 a of the crimping actuator 188 , the firing nut 163 can rotate the crimping actuator 188 upwardly into an actuated position as illustrated in FIG. 8 .
- the distal arm 190 a and a proximal arm 190 b can each comprise a projection, such as projections 191 a and 191 b , respectively, extending therefrom which can be positioned within a second longitudinal slot defined in shaft 110 , such as slot 115 , for example.
- the projections 191 a and 191 b can move from the proximal curved end 116 of the longitudinal slot 115 into a portion of the longitudinal slot 115 which is substantially linear.
- the sidewalls of the longitudinal slot 115 can be configured to confine the movement of the crimping actuator 188 along a longitudinal path and can be configured to limit or prevent the rotation of the crimping actuator 188 once the crimping actuator 188 has been rotated upwardly into an at least partially actuated position, as discussed above.
- the firing pin 172 of the firing drive 160 and the firing pin 184 of the crimping drive 180 both extend from the firing nut 163 .
- the firing pins 172 and 184 are illustrated as extending from the same side of the firing nut 163 ; however, it is envisioned that the firing pin 172 can extend from a first lateral side of the firing nut 163 while the firing pin 184 can extend from the other lateral side of the firing nut 163 .
- the firing actuator 168 can be positioned alongside the first lateral side of the drive screw 161 and the crimping actuator 188 can be positioned alongside the opposite lateral side of the drive screw 161 .
- the longitudinal slot 113 can be defined in a first lateral side of the shaft housing 112 while the longitudinal slot 115 can be defined in the opposite lateral side of the shaft housing 112 .
- the cam actuator 181 can be operably coupled with crimping actuator 188 such that, when the crimping actuator 188 is advanced distally by the firing nut 163 , the cam actuator 181 can be advanced distally, as illustrated in FIGS. 8 and 10 , until the distal projection 191 a extending from the distal arm 190 a reaches the distal end 117 of the longitudinal slot 115 . In such a distal position, the cam actuator 181 may be in a fully advanced position and the clip 140 positioned within the receiving chamber 122 can be in a fully deformed or crimped configuration. Thereafter, the cam actuator 181 can be retracted and the end effector 120 can be reopened.
- the drive screw 161 can be rotated in an opposite direction in order to move the firing nut 163 proximally and retract the cam actuator 181 wherein, in certain instances, the end effector 120 can further include a biasing member which can be configured to bias the first jaw 123 and the second jaw 123 b from the closed, or fired, position illustrated in FIG. 4 into the open, or unfired, position illustrated in FIG. 3 . As the firing nut 163 is retracted from its position illustrated in FIG.
- the firing pin 184 extending from the firing nut 163 can engage the proximal arm 190 b of the crimping actuator 188 and move the crimping actuator 188 , and the cam actuator 181 extending therefrom, proximally as illustrated in FIG. 12 .
- the proximal projection 191 b extending from the proximal arm 190 b of the crimping actuator 188 can be configured to contact the sidewall of the curved proximal end 116 wherein the sidewall can guide the crimping actuator 188 downwardly and rotate the crimping actuator 188 about the pivot 189 .
- the firing pin 184 may no longer be engaged with the crimping actuator 188 , the cam actuator 181 may be fully retracted, and the firing nut 163 may continue to be retracted proximally relative to the crimping actuator 188 .
- the firing nut 163 can be configured to re-engage the firing actuator 168 as the firing nut 163 is being retracted proximally.
- the firing actuator 168 is rotated downwardly when the firing actuator 168 reaches the distal end 114 of the longitudinal slot 113 and, as a result, the firing actuator 168 may still be in its downwardly rotated position when the firing nut 163 is retracted proximally to re-engage the firing actuator 168 .
- FIG. 11 the firing nut 163 can be configured to re-engage the firing actuator 168 as the firing nut 163 is being retracted proximally.
- the firing pin 172 extending from the firing nut 163 can engage the proximal arm 170 b of the firing actuator 168 and, as the firing nut 163 is further retracted, the firing nut 163 can rotate the firing actuator 168 upwardly such that the projections 171 a and 171 b extending from the arms 170 a and 170 b , respectively, can re-enter the longitudinal portion of the longitudinal slot 113 . Thereafter, the firing nut 163 and can be retracted until the firing actuator 168 and the firing member 165 extending therefrom have been returned to their starting, or unfired, positions illustrated in FIG. 5 .
- the firing member 165 can be withdrawn from the clip cartridge 130 as the firing member 165 is retracted proximally by the firing nut 163 such that a new clip 140 can be biased into the firing chamber of the clip cartridge 130 by the biasing member 136 .
- the firing drive 160 can be actuated once again in order to move the firing nut 163 and the firing member 165 distally to advance the next clip 140 into the end effector 120 .
- the firing nut 163 can re-actuate the crimping drive 180 as the firing nut 163 is moved distally once again in order to deform the next clip 140 . Thereafter, the firing nut 163 can retracted in order to re-set the crimping drive 180 and the firing drive 160 once again. This process can be repeated until a sufficient number of clips 140 have been applied to the targeted tissue and/or until the clips 140 contained within the clip cartridge 130 have been depleted. In the event that additional clips 140 are needed, the expended clip cartridge 130 can be removed from the shaft 110 and a replacement clip cartridge 130 containing additional clips 140 can be inserted into the shaft 110 .
- an at least partially depleted clip cartridge 130 can be replaced with an identical, or at least nearly identical, replacement clip cartridge 130 while, in other circumstances, the clip cartridge 130 can be replaced with a clip cartridge having more than or less than five clips 140 contained therein and/or a clip cartridge having clips other than clips 140 contained therein, for example.
- the firing nut 163 of the illustrated embodiment can be configured to become disengaged from the firing actuator 168 at the same time that the firing nut 163 becomes engaged with the crimping actuator 188 .
- the firing drive 160 can be deactivated at the same time that the crimping drive 180 is activated.
- timing can be achieved when the distal end 114 of the longitudinal slot 113 is aligned, or at least substantially aligned, with the proximal end 116 of the second longitudinal slot 115 , for example.
- a lag can exist between the deactivation of the firing drive 160 and the activation of the crimping drive 180 .
- Such a lag between the end of the firing stroke of the firing member 165 and the beginning of the firing stroke of the cam actuator 181 can be created, in some circumstances, to assure that the clip 140 has been positioned in its fully-seated position within the receiving chamber 122 before the clip 140 is deformed by the cam actuator 181 .
- such a lag can be created when the distal end 114 of the longitudinal slot 113 is positioned proximally with respect to the proximal end 116 of the second longitudinal slot 115 , for example.
- the deactivation of the firing drive 160 may occur after the activation of the crimping drive 180 .
- Such an overlap between the end of the firing stroke of the firing member 165 and the beginning of the firing stroke of the cam actuator 181 can be created, in some circumstances, to apply at least some inward pressure on the clip 140 as it is moved into its fully-seated position within the receiving chamber 122 so as to reduce or eliminate relative movement between the clip 140 and the sidewalls of the receiving chamber 122 , for example.
- such an overlap can be created when the distal end 114 of the longitudinal slot 113 is positioned distally with respect to the proximal end 116 of the second longitudinal slot 115 , for example.
- a clip cartridge such as clip cartridge 230
- the pusher plate 248 can be rigid, or at least substantially rigid, and can comprise a first bearing surface against which the biasing member 136 can apply a biasing force.
- the pusher plate 248 can also comprise a second bearing surface which can transmit the biasing force to the top surface 145 of the top-most clip 140 .
- the pusher plate 248 can be comprised of a sheet of stainless steel material, for example, although the pusher plate 248 can comprise any suitable shape and can be comprised of any suitable material. In certain instances, the pusher plate 248 may not be attached to the biasing member 136 while, in other instances, the pusher plate 248 can be affixed to the biasing member 136 such that the pusher plate 248 does not become dislodged from the cartridge housing 132 . In various circumstances, the pusher plate 248 can be sized and configured such that it cannot pass through the proximal opening 133 and/or the distal opening 137 defined in the cartridge housing 132 .
- a clip cartridge such as clip cartridge 330
- the lockout member can comprise a lockout plate 348 which can be positioned intermediate the biasing member 136 and the top surface 145 of the top-most clip 140 contained within the clip cartridge 330 .
- the clips 140 can be sequentially positioned in the firing chamber 149 of the clip cartridge 130 and then advanced distally out of the clip housing 132 wherein, after the last clip 140 has been advanced out of the clip housing 132 and the firing member 165 has been withdrawn from the clip cartridge 130 , the biasing member 136 can bias the lockout plate 348 against the shelves 135 . In such a position, the lockout plate 348 can be aligned with the proximal opening 133 and the distal opening 137 such that the firing member 165 cannot enter, or at least substantially enter, the clip cartridge 130 .
- the lockout plate 348 can block the firing member 165 from entering into and passing through the housing 132 and, as a result, prevent the inadvertent firing of the clip applier 100 after the clip cartridge 130 has run out of clips.
- the firing member 165 would contact and abut the lockout plate 348 wherein, in such circumstances, a compressive load can be created within the firing member 165 .
- the clip applier 100 can further include a clutch which can be configured to slip and operably disconnect the motor from the drive screw 161 when the compressive load created within the firing member 165 exceeds a certain or predetermined amount.
- the motor and/or motor controller of the clip applier 100 which operates the firing drive 160 can comprise a load sensor configured to detect the load generated within the firing member 165 and, when the load created within the firing member 165 exceeds a certain or predetermined amount, the voltage and/or current supplied to the motor can be switched off and/or reduced.
- the lockout plate 348 can be sized and configured such that the lockout plate 348 cannot be dislodged through the distal opening 137 and/or the proximal opening 133 when the firing member 165 contacts the lockout plate 348 .
- the operator of the clip applier 100 can remove the spent cartridge 330 from the shaft 110 and insert a new clip cartridge 330 , for example, into the shaft 110 .
- a clip 140 may be positioned within the firing chamber 149 of the new clip cartridge 330 and the firing member 165 can be advanced distally into the new clip cartridge 330 to deploy the clip 140 as described above.
- a clip cartridge such as clip cartridge 430
- the lockout member can comprise a lockout plate 448 , for example, which can be positioned intermediate the biasing member 136 and the top surface 145 of the top-most clip 140 contained within the housing 432 of the clip cartridge 430 .
- the lockout plate 448 can be progressively pushed downwardly into the firing chamber 149 as the clips 140 are sequentially ejected from the clip cartridge 430 .
- the lockout plate 448 can be sized and configured such that it is closely received within the cartridge housing 432 and such that relative lateral movement between the lockout plate 448 and the housing 432 can be limited in order to reduce, or prevent, the possibility of the lockout plate 448 becoming misaligned within the clip cartridge 430 .
- the lockout plate 448 may bind within the housing 432 and prevent the biasing member 136 from applying an appropriate biasing force to the stack of clips 140 , for example.
- the lockout plate 438 can further comprise guide members 447 extending therefrom which can be received within guide slots 446 defined in the cartridge housing 432 .
- the guide members 447 and the guide slots 446 can be sized and configured such that the guide members 447 are closely received within the guide slots 446 and such that relative lateral movement between the lockout plate 438 and the cartridge housing 432 can be limited.
- Each of the guide slots 446 can be defined by opposing sidewalls 445 which can define a distance therebetween which is equal to or slightly larger than the width of the guide member 447 positioned therein such that the guide member 447 can slide between the opposing sidewalls 445 between the top 443 and the bottom 444 of the guide slot 446 .
- the guide members 447 and the guide slots 446 can be configured to limit lateral movement therebetween, as outlined above, the guide members 447 and the guide slots 446 can be configured to permit relative movement between the lockout plate 438 and the cartridge housing 432 along a predetermined path parallel to or collinear with the supply axis 138 , for example.
- the lockout plate 438 When the lockout plate 438 is pushed into the firing chamber 149 by the biasing member 136 , the lockout plate 438 can inhibit the advancement of the firing member 165 and the operation of the clip applier 100 , as outlined above, until the spent clip cartridge 430 is replaced with another suitable clip cartridge.
- the drive screw 161 can be rotated in a first direction to advance the firing nut 163 distally and rotated in a second, or reverse, direction to retract the firing nut 163 proximally.
- the electric motor operably coupled with the drive screw 161 can be operated in corresponding first and second directions.
- a clip applier can utilize a motor which is operated in only a first direction wherein the rotation of the motor in such a single direction can be utilized to advance a firing nut distally and retract the firing nut proximally.
- the output of an electric motor can be transmitted to a drive system 560 via a transmission system 550 .
- the transmission system 550 can comprise an input shaft 552 which is operated in a single direction wherein the transmission system 550 can be switchable or shiftable between a first state, or configuration, in which the transmission system 550 rotates a drive screw 561 of the drive system 560 in a first direction and a second state, of configuration, in which the transmission system 550 rotates the drive screw 561 in a second, or opposite, direction.
- the first state of the transmission system 550 is depicted in FIGS. 22-24 and the second state of the transmission system 550 is depicted in FIGS. 25 and 26 .
- the input shaft 552 can comprise an input gear 551 mounted thereto which is operably coupled, or meshingly engaged, with a shifter gear 553 such that the rotation of the input shaft 552 is transmitted to the shifter gear 553 .
- gears which are operably coupled or meshingly engaged with one another can comprise any suitable arrangement of teeth, for example, which can transmit the rotation of one gear to the other.
- the shifter gear 553 In the first state of the transmission system, the shifter gear 553 is in a first position in which the shifter gear 553 is operably coupled with an intermediate gear 554 wherein, when the shifter gear 553 is rotated in the second direction by the input gear 551 , as discussed above, the intermediate gear 554 is rotated in the first direction.
- the intermediate gear 554 can be rotatably supported within the shaft 110 of the clip applier 100 , for example.
- the intermediate gear 554 can also be operably coupled with an output gear 555 mounted to the drive screw 561 such that the rotation of the intermediate gear 554 can be transmitted to the output gear 555 .
- the intermediate gear 554 When the intermediate gear 554 is driven in the first direction by the shifter gear 553 , as described above, the intermediate gear 554 can drive the output gear 555 and the drive screw 561 in the second direction. Similar to the above, the firing nut 563 can be operably coupled with the drive screw 561 and suitably constrained within the shaft 110 such that, when the drive screw 561 is rotated in the second direction, the firing nut 563 is advanced distally as indicated by the arrow D.
- the firing nut 563 can be advanced to its distal-most position, illustrated in FIG. 24 , in order to advance a clip 140 from the clip cartridge 130 into the end effector 120 and crimp the clip 140 as described above.
- the firing nut 563 can further comprise a cam bar 569 extending therefrom which can be configured to shift the transmission system 550 from its first state to its second state.
- the shifter gear 553 is movable between a first position in which the transmission system 550 is in its first state and a second position in which the transmission system 550 is in its second state.
- the shifter gear 553 is mounted to a shifter 556 which is rotatable about the input shaft 552 such that the shifter gear 553 can be rotated from its first position in which the shifter gear 553 is operably engaged with the input gear 551 and the intermediate gear 554 and its second position in which the shifter gear 553 is operably disengaged from the intermediate gear 554 .
- the shifter gear 553 is operably disengaged from the intermediate gear 554 when the shifter gear 553 is in its second position, the shifter gear 553 can be operably coupled with the input gear 551 and the output gear 555 in order to transmit rotary motion from the input shaft 552 to the drive screw 561 . As illustrated in FIGS.
- the shifter 556 can comprise a central aperture through which the input shaft 552 can extend; however, the shifter 556 may not be operably engaged with the input shaft 552 and, as a result, the rotation of the input shaft 552 may not rotate the shifter 556 and, likewise, the rotation of the shifter 556 may not rotate the input shaft 552 .
- the shifter 556 can further comprise a cam follower 558 extending therefrom which can be engaged by a cam 568 defined on the cam bar 569 as the firing nut 563 is advanced distally. When the cam 568 engages the cam follower 558 , the cam 568 can rotate the shifter 556 and the shifter gear 553 between its first position and its second position as described above.
- the input shaft 552 and the drive screw 561 can both be rotated in the first direction. More particularly, the input shaft 552 , when rotated in the first direction, can rotate the input gear 551 in the first direction and, as the shifter gear 553 is directly engaged with the input gear 551 , the shifter gear 553 will be rotated in the second direction.
- the shifter gear 553 rotates in the second direction when the transmission system 550 is in its second state as compared to the first, or opposite, direction when the transmission system 550 is in its first state.
- the intermediate gear 554 is no longer operably positioned intermediate the input gear 551 and the shifter gear 553 when the transmission system 550 is in its second state thereby accounting for the different directions of rotation.
- the shifter gear 553 can rotate the output gear 555 , and the drive screw 561 coupled to the output gear 555 , in the first direction.
- the drive screw 561 is rotated in the first direction, as illustrated in FIGS.
- the firing nut 563 can be retracted proximally to permit the end effector 120 to be reopened and to retract the firing member 165 .
- the firing nut 563 can further comprise a second cam bar 567 extending therefrom comprising a cam 566 which can be configured to contact the cam follower 558 of the shifter 556 as the firing nut 563 is retracted proximally into its fully-retracted position. In such circumstances, the cam 566 can push the shifter 556 back into its first position and into operative engagement with the intermediate gear 554 such that the transmission system 550 can be reset into its first state and the clip applier 100 can be actuated once again.
- the firing drive of the clip applier 100 can be operated by a surgical instrument system comprising an electric motor.
- a robotic surgical instrument system 20 is illustrated in FIG. 27 and can comprise a plurality of movable arms 30 .
- Each arm 30 can comprise an actuator module 32 comprising an electric motor configured to supply the rotary motion to the shaft 110 of a clip applier 100 , and/or any other suitable surgical instrument.
- an end effector 620 may be selectively engageable with and disengageable from an actuator shaft 610 of a clip applier wherein the end effector 620 can comprise a proximal end 621 which can be coupled to a distal end 611 of the shaft 610 .
- the proximal end 621 of the end effector 620 can comprise an outer housing 629 , a frame extending through the outer housing 629 , an outer drive shaft extending through the frame, and an inner drive shaft extending through the outer drive shaft.
- the distal end 611 of the shaft 610 can comprise an outer housing 619 , a frame 663 extending through the outer housing 619 , an outer drive shaft 662 extending through the frame 663 , and an inner drive shaft 661 extending through the outer drive shaft 662 .
- the frame 663 , the outer drive shaft 662 , and the inner drive shaft 661 can each comprise a portion of a tongue connector 613 extending therefrom and a portion of a connector groove 612 defined therein, wherein the tongue connector 613 can be configured to be received within a tongue groove 623 defined in the proximal end 621 of the end effector 620 , and wherein the tongue groove 612 can be configured to receive a tongue connector 622 extending from the proximal end 621 of the end effector 620 .
- the tongue connector 622 can extend across the frame, the outer drive shaft, and the inner drive shaft of the proximal end 621 of the end effector 620 .
- the tongue groove 623 can extend across the frame, the outer drive shaft, and the inner drive shaft of the proximal end 621 of the end effector 620 .
- the tongue connector 622 of the end effector 620 can be slid laterally into the tongue groove 612 of the shaft 610 at the same time that the tongue connector 613 of the shaft 610 is slid laterally into the tongue groove 623 of the end effector 620 .
- the frame of the end effector 620 can be securely coupled to the frame 663 of the shaft 610
- the outer drive shaft of the end effector 620 can be operably coupled to the outer drive shaft 662 of the shaft 110
- the inner drive shaft of the end effector 620 can be operable coupled to the inner drive shaft 661 of the shaft 110 .
- the portions of the tongue connector 612 are aligned with one another, the portions of the tongue groove 613 are aligned with one another, the portions of the tongue groove 622 are aligned with one another, and the portions of the tongue connector 623 are aligned with one another when the end effector 620 is assembled to the shaft 610 .
- the outer drive shaft 662 of the shaft 110 can rotate the outer drive shaft of the end effector 620
- the inner drive shaft 661 of the shaft 610 can rotate the inner drive shaft of the end effector 620 .
- the portions of the tongue connector 612 , the portions of the tongue groove 613 , the portions of the tongue groove 622 , and the portions of the tongue connector 623 may no longer be aligned.
- the inner drive shaft 661 and/or the outer drive shaft 662 can be rotated into one or more positions in which the tongue connectors 612 and 623 and the tongue grooves 613 and 622 are sufficiently aligned.
- the outer housing 619 of the shaft 610 can further comprise a stop 614 which can be configured to limit the lateral movement of the end effector 620 as the end effector 620 is being slid transversely onto the distal end 611 of the shaft 610 .
- the stop 614 can provide a datum from which the inner drive shaft of the end effector 620 and the inner drive shaft 661 of the shaft 610 are aligned along longitudinal axis 615 , the outer drive shaft of the end effector 620 and the other drive shaft 662 of the shaft 610 are aligned along longitudinal axis 615 , and/or the frame of the end effector 620 and the frame 663 of the shaft 610 are aligned along the longitudinal axis 615 .
- the inner drive shaft 661 can extend into an actuator module 632 which can comprise an electric motor and/or gear train 664 operably coupled with the inner drive shaft 661 configured to rotate the inner drive shaft 661 .
- the actuator module 632 can comprise a second electric motor and gear train operably engaged with the second drive shaft 662 configured to drive the second drive shaft 662 .
- a second electric motor can be utilized to articulate the end effector 620 .
- the outer housing 619 and/or the frame 663 of the shaft 610 can further comprise a gear 617 mounted thereto which is operably engaged with an electric motor and gear train 618 which can be configured to rotate the shaft 610 and the end effector 620 about the longitudinal axis 615 .
- the shaft 610 and the end effector 620 can be rotated about the axis 615 in a clockwise direction while, if the electric motor and gear train 618 are operated in a second direction, the shaft 610 and the end effector 620 can be rotated about the axis 615 in a counter-clockwise direction in order to position and orient the end effector 620 .
- the end effector 620 can be selectively attached to and detached from the shaft 610 .
- the reader will note that the principles discussed in connection with the end effector 620 and shaft 610 can be equally applied to the end effector 120 and the shaft 110 of the embodiment disclosed in FIG. 1 , among others. That said, referring again to FIG. 27 , one of the robotic arms 30 can be selectively engaged with an end effector 120 of a clip applier or, alternatively, any other suitable end effector, such as the end effector of a surgical stapler, for example. In such circumstances, an end effector 120 can be selectively interchanged with another end effector and, as a result, a single robotic arm 30 can be utilized to perform more than one function.
- the clip applier 100 can comprise a replaceable loading unit which can be replaced by, or interchanged with, another clip applier loading unit and/or any other suitable replaceable loading unit.
- the end effector 120 and the shaft 110 of the clip applier 100 can be utilized with a surgical instrument system comprising a handle 700 .
- the handle 700 can comprise an actuator 701 which can be operated, or squeezed toward grip 702 , in order to apply a rotary motion to the drive screw 161 as described above.
- the rotation of the actuator 701 can be mechanically transmitted to the drive screw 161 while, in other cases, the actuator 701 can operate a motor operably coupled to the drive screw 161 .
- the end effector 120 and the shaft 110 of the clip applier 100 can be aligned along a longitudinal axis of the clip applier 100 .
- the end effector 120 and/or the shaft 110 can further comprise an articulation joint 101 which can be configured to permit the end effector 120 to be articulated relative to the longitudinal axis of the clip applier 100 .
- the shaft 110 can comprise an outer housing, or frame portion, 119 which can comprise a proximal end 102 and can comprise a distal portion of the articulation joint 101 .
- the proximal end 102 can comprise a spherical, or an at least substantially spherical, end 102 , for example, which can be received within a spherical, or an at least substantially spherical, cavity 104 defined in an articulation joint member 103 .
- the articulation joint member 103 can also comprise a spherical, or at least substantially spherical, end 105 , for example, which can be received within a spherical, or an at least substantially spherical, cavity 107 defined in a shaft frame portion 106 .
- the proximal end 102 of the shaft 110 can be at least partially captured within the cavity 104 such that the proximal end 102 cannot be readily removed from the cavity 104 . That said, the proximal end 102 and the cavity 104 can be sized and configured to permit the proximal end 102 to be rotated in any suitable direction within the cavity 104 .
- the clip applier 100 can further comprise articulation controls 108 a and 108 b , for example, which can extend through the articulation joint 101 and can comprise distal ends mounted within mounting apertures 109 a and 109 b , respectively, defined within the proximal end 102 of the shaft housing 119 .
- the articulation controls 108 a and 108 b can be pushed and/or pulled in order to move the proximal end 102 within the cavity 104 .
- the end 105 of the articulation joint member 103 can be at least partially captured within the cavity 107 defined in the shaft frame portion 106 such that the end 105 cannot be readily removed from the cavity 107 . That said, the end 105 and the cavity 107 can be sized and configured to permit the end 105 to be rotated in any suitable direction within the cavity 107 when the shaft end 102 is pushed and/or pulled by the actuators 108 a and 108 b as described above.
- the drive screw 161 can be rotated by an input shaft, such as input shaft 152 , for example.
- the input shaft 152 can extend through an aperture 156 defined within the shaft frame portion 106 , the articulation joint member 103 , and the proximal end 102 of the shaft housing 119 .
- the input shaft 152 can comprise an input gear 151 mounted to the distal end thereof which can be operably coupled with an output gear 155 mounted to the proximal end of the drive screw 161 .
- the input shaft 152 can be rotated by the electric motor, described above, wherein the input shaft 152 can rotate the drive screw 161 .
- the articulation joint 101 can be configured to permit the end effector 120 and at least a portion of the shaft 110 to be articulated relative to a longitudinal axis defined by the clip applier 100 .
- at least the portion of the input shaft 152 extending through the articulation joint 101 can be sufficiently flexible.
- the articulation actuators 108 a and 108 b can be operated by an actuator module such as module 832 , for example.
- the actuator module 832 can comprise a rotatable articulation driver 833 which can be configured to push and pull the articulation actuators 108 a and 108 b .
- the articulation driver 833 can comprise a cylindrical, or an at least substantially cylindrical, collar 835 including an aperture 837 which can be configured to receive at least a portion of the shaft frame 106 therein in order to rotatably support the collar 835 .
- the articulation driver 833 can further comprise an input gear portion 834 which can be operably coupled with an electric motor and gear train 831 of the module 832 wherein, when the electric motor and gear train 831 are actuated, the articulation driver 833 can be rotated about the shaft frame 106 .
- the articulation driver 833 can further comprise two cam slots defined in the sidewall of the collar aperture 837 , although the reader will note that only one cam slot 835 a is illustrated in the provided views.
- the cam slot 835 a is configured to receive a cam follower 838 a extending from the articulation driver 108 a wherein the cam follower 838 a is configured to slide within the cam slot 835 a .
- the helical contour of the cam slot 835 a can be configured to push the cam follower 838 a distally or pull the cam follower 838 proximally, depending on the direction in which the articulation driver 833 is rotated.
- the cam actuator 108 a can be moved proximally or distally, respectively.
- the articulation driver 108 b can comprise a cam follower, similar to the cam follower 838 a , which can be configured to slide within the other cam slot discussed above.
- the other cam slot can be configured such that, when the articulation actuator 108 a is driven distally by the articulation driver 833 when the articulation driver 833 is rotated in a first direction, the articulation actuator 108 b can be pulled proximally.
- the other cam slot can be configured such that, when the articulation actuator 108 a is pulled proximally by the articulation driver 833 when the articulation driver 833 is rotated in a second direction, the articulation actuator 108 b can be driven distally.
- the shaft frame portion 106 can comprise clearance slots 839 defined therein through which the cam actuators 838 can extend.
- a clip applier loading unit can comprise a shaft including a distal end, a proximal end, and a frame comprising a frame connector configured to be releasably attached to a frame of an actuator.
- the clip applier loading unit can further comprise a plurality of clips and an end effector extending from the distal end of the shaft, wherein the end effector comprises a first jaw, a movable second jaw, and a receiver defined between the first jaw and the second jaw.
- the receiver is configured to receive a clip, wherein the second jaw is movable toward the first jaw to deform the clip positioned in the receiver.
- the clip applier loading unit can further comprise a firing drive comprising a distal portion configured to advance a clip into the receiver and a proximal portion comprising a drive connector configured to be releasably attached to a driver of the actuator.
- a clip applier loading unit can comprise a shaft comprising a distal end, a proximal end, a frame comprising a frame connector configured to be releasably attachable to and detachable from a frame of an actuator unit, and a bearing.
- the clip applier loading unit can further comprise a plurality of clips and an end effector extending from the distal end of the shaft, wherein the end effector comprises a first jaw, a second jaw movable relative to the first jaw, and a receiver defined between the first jaw and the second jaw, wherein the receiver is configured to receive a clip.
- the clip applier loading unit can further comprise a reciprocating rotary firing drive comprising a rotatable driver comprising a thread, wherein the rotatable driver is rotatably supported by the bearing, and, in addition, a firing nut threadably engaged with the thread of the rotatable driver, wherein the firing nut is advanceable toward the distal end when the driver is rotated in a first direction, wherein the firing nut is retractable away from the distal end when the driver is rotated in a second direction opposite the first direction, and wherein the firing nut is configured to advance a clip into the receiver when the firing nut is advanced toward the distal end.
- a clip applier loading unit comprising a shaft including a distal end, a proximal end, a frame, and connection means for releasably attaching the frame to an actuator.
- the clip applier can further comprise a plurality of clips and an end effector extending from the distal end of the shaft, wherein the end effector comprises a first jaw, a movable second jaw, and a receiver defined between the first jaw and the second jaw, wherein the receiver is configured to receive a clip, and wherein the second jaw is movable toward the first jaw to deform a clip positioned in the receiver.
- the clip applier loading unit can further comprise firing means for advancing a clip into the receiver.
- a clip applier for clipping tissue can comprise a shaft including a distal portion, a distal opening defined in the distal portion, and a magazine opening.
- the clip applier can further comprise a magazine assembly removably positionable in the magazine opening, wherein the magazine assembly comprises a housing, a storage chamber defined in the housing, a firing platform, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to bias the clips toward the firing platform.
- the clip applier can further comprise a firing drive configured to advance a clip from the magazine through the distal opening.
- a magazine assembly for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a firing platform, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to bias the clips toward the firing platform.
- a clip applier surgical instrument can comprise a shaft including a distal portion and a cartridge receptacle, and a cartridge assembly removably positionable in the cartridge receptacle.
- the cartridge assembly can comprise a housing, a storage chamber defined in the housing, a discharge opening, a stack of clips removably positioned within the storage chamber, wherein the stack of clips comprises a plurality of clips stacked on top of one another, and a biasing member configured to align a clip with the discharge opening.
- the clip applier surgical instrument can further comprise a firing drive configured to advance a clip from the magazine through the discharge opening.
- a cartridge assembly for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a discharge opening, a stack of clips removably positioned within the storage chamber, wherein the stack of clips comprises a plurality of clips stacked on top of one another, and a biasing member configured to align a clip with the discharge opening.
- a surgical device for applying clips can comprise a shaft including a distal portion, a loading port defined in the distal portion, and a discharge opening.
- the surgical device can further comprise a clip cartridge removably positionable in the loading port, wherein the clip cartridge comprises a stack of clips, a biasing member configured to align a clip with the discharge opening, and a firing drive configured to advance a clip from the clip cartridge through the discharge opening.
- a clip cartridge removably for use with a clip applier can be positionable in a loading port of the clip applier, wherein the clip cartridge can comprise a stack of clips and a biasing member configured to align a clip with a discharge opening.
- a surgical device for applying clips can comprise a shaft, supply means for supplying a plurality of clips along a supply axis, and firing means for advancing a clip from a pre-fired position to a fired position along a firing axis, wherein the supply axis is transverse to the firing axis.
- a clip applier for clipping tissue comprising a shaft, a firing chamber, an end effector extending from the shaft, wherein the end effector comprises a crimping chamber, and a magazine assembly comprising a housing, a storage chamber defined in the housing, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber.
- the clip applier can further comprise a reciprocating firing drive configured to advance a clip positioned in the firing chamber into the crimping chamber, and a lockout plate positioned intermediate the biasing member and the plurality of clips, wherein the biasing member is configured to bias the lockout plate into the firing chamber after all of the plurality of the clips have been advanced into the crimping chamber, and wherein the lockout plate is configured to block the firing drive.
- a magazine assembly for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber.
- the magazine assembly can further comprise a lockout plate positioned intermediate the biasing member and the plurality of clips, wherein the biasing member is configured to bias the lockout plate into the firing chamber after all of the plurality of the clips have been advanced from the housing, and wherein the lockout plate is configured to block a firing drive from entering the firing chamber.
- a surgical device for applying clips can comprise a shaft, an end effector comprising a receiver, and a cartridge comprising a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing platform, and a biasing member configured to sequentially bias the clips from the storage chamber onto the firing platform.
- the surgical device can further comprise a reciprocating firing drive configured to advance a clip positioned on the firing platform into the receiver, and a lockout member positioned intermediate the biasing member and the stack of clips, wherein the biasing member is configured to bias the lockout member against the firing platform after all of the clips have been advanced into the receiver, and wherein the lockout member is configured to block the firing drive.
- a cartridge for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing platform, and a biasing member configured to sequentially bias the clips from the storage chamber onto the firing platform.
- the cartridge can further comprise a lockout member positioned intermediate the biasing member and the stack of clips, wherein the biasing member is configured to bias the lockout member against the firing platform after all of the clips have been advanced out of the housing, and wherein the lockout member is configured to block a firing drive from passing through the housing.
- a surgical device for clipping tissue can comprise a shaft, an end effector comprising a receiver, and a cartridge comprising a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber.
- the surgical device can further comprise a reciprocating firing drive configured to advance a clip positioned in the firing chamber into the receiver during a firing stroke, and blocking means for inhibiting the firing drive from completing a firing stroke after all of the clips have been advanced into the receiver.
- a cartridge for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber.
- the cartridge can further comprise blocking means for inhibiting a firing drive from completing a firing stroke after all of the clips have been advanced from the housing.
- the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure.
- reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Abstract
Description
- A variety of fasteners can be utilized to treat, clamp, fasten, secure, and/or hold tissue. Clips can be positioned relative to tissue located within a surgical site in a patient and then deformed to apply a clamping force, for example, to the tissue.
- The features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of exemplary embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
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FIG. 1 is a partial perspective view of a clip applier; -
FIG. 2 is a cross-sectional view of an end effector of the clip applier ofFIG. 1 comprising a removable clip cartridge, a reciprocating firing drive for sequentially advancing the clips, a receiver for receiving the clips, and a crimping drive for deforming the clips; -
FIG. 3 is a partial cross-sectional view of the clip applier ofFIG. 1 in an open configuration; -
FIG. 4 is a partial cross-sectional view of the clip applier ofFIG. 1 in a closed configuration; -
FIG. 5 is a cross-sectional view of the end effector ofFIG. 2 in an unfired condition; -
FIG. 6 is a cross-sectional view of the end effector ofFIG. 2 illustrating the firing drive in a partially fired condition in which a firing member of the firing drive has advanced a clip into the receiver; -
FIG. 7 is a cross-sectional view of the end effector ofFIG. 2 illustrating the firing drive coming into engagement with the crimping drive; -
FIG. 8 is a cross-sectional view of the end effector ofFIG. 2 illustrating the crimping drive in an at least partially fired condition; -
FIG. 9 is a cross-sectional view of the end effector ofFIG. 2 illustrating the firing drive becoming disengaged from the firing member; -
FIG. 10 is a cross-sectional view of the end effector ofFIG. 2 illustrating the crimping drive in its fully fired condition; -
FIG. 11 is a cross-sectional view of the firing drive of the end effector ofFIG. 2 in a partially retracted position in which the firing drive is being re-engaged with the firing member; -
FIG. 12 is a cross-sectional view of the firing drive of the end effector ofFIG. 2 being disengaged from the crimping drive; -
FIG. 13 is a perspective view of a clip illustrated inFIGS. 2-12 ; -
FIG. 14 is a front view of a cartridge illustrated inFIGS. 1-12 comprising a plurality of clips with portions of the cartridge removed to illustrate the clips stored in the cartridge; -
FIG. 15 is a side view of the cartridge ofFIG. 14 illustrated with portions removed to illustrate the clips stored in the cartridge; -
FIG. 16 is a cross-sectional plan view of the cartridge ofFIG. 14 taken along line 16-16 inFIG. 15 ; -
FIG. 17 is a side view of an alternative cartridge usable in connection with the clip applier ofFIGS. 1-12 or any other suitable clip applier, wherein the cartridge is illustrated with portions removed to illustrate a biasing member and a pusher plate positioned intermediate the biasing member and the clips contained therein; -
FIG. 18 is a side view of a cartridge in accordance with at least one alternative embodiment illustrated with portions removed to illustrate a biasing member and a lockout plate positioned intermediate the biasing member and the clips contained therein; -
FIG. 19 is a cross-sectional plan view of the cartridge ofFIG. 18 taken along line 19-19 inFIG. 18 ; -
FIG. 20 is a side view of a further alternative cartridge usable in connection with the clip applier ofFIGS. 1-12 or any other suitable clip applier, wherein the cartridge can comprise a housing illustrated with portions removed to illustrate a lockout plate comprising guides which are configured to co-operate with guides defined in the cartridge housing; -
FIG. 21 is a cross-sectional plan view of the cartridge ofFIG. 20 taken along line 21-21 inFIG. 20 ; -
FIG. 22 is an elevational view of a firing drive comprising a rotary input, a rotary output, a firing nut engaged with the rotary output, and a transmission in a firing configuration in accordance with at least one embodiment; -
FIG. 23 is a perspective view of the firing drive ofFIG. 22 illustrating the firing nut in an unfired position; -
FIG. 24 is a perspective view of the firing drive ofFIG. 22 illustrating the firing nut advanced along the rotary output and a cam extending from the firing nut; -
FIG. 25 is a perspective view of the firing drive ofFIG. 22 illustrating the cam of the firing nut engaged with the transmission of the firing drive and the transmission in a reverse configuration; -
FIG. 26 is a perspective view of the firing drive ofFIG. 22 illustrating firing nut in a retracted position and a second cam extending from the firing nut engaged with the transmission to shift the transmission from its reverse configuration to its firing configuration; -
FIG. 27 is a perspective view of a robotic surgical instrument system operably supporting a plurality of surgical tools usable with the clip applier ofFIGS. 2-12 or any other suitable clip applier; -
FIG. 28 is a perspective view of a surgical tool including an actuator module, a shaft extending from the actuator module, and a replaceable end effector; -
FIG. 29 is a perspective view of a handle actuator usable with the clip applier ofFIGS. 2-12 or any other suitable clip applier; -
FIG. 30 is a cross-sectional view of the articulation joint illustrated inFIG. 2 ; -
FIG. 31 is a rear perspective view of an alternative actuator module that may be used in place of the actuator module ofFIG. 28 with at least a portion of its housing removed; -
FIG. 32 is an exploded view of a portion of the actuator module ofFIG. 31 ; -
FIG. 33 is a partial sectional view of the actuator module ofFIG. 31 ; and -
FIG. 34 is a cross-sectional view of an articulation actuator of the actuator module ofFIG. 31 . - Applicant of the present application also owns the following patent applications that have been filed on even date herewith and which are each herein incorporated by reference in their respective entireties:
- U.S. patent application Ser. No. ______, entitled “Flexible Drive Member,” (Attorney Docket No. END7131USNP/120135).
- U.S. patent application Ser. No. ______, entitled “Multi-Functional Powered Surgical Device with External Dissection Features,” (Attorney Docket No. END7132USNP/120136).
- U.S. patent application Ser. No. ______, entitled “Coupling Arrangements for Attaching Surgical End Effectors to Drive Systems Therefor,” (Attorney Docket No. END7133USNP/120137).
- U.S. patent application Ser. No. ______, entitled “Rotary Actuatable Closure Arrangement for Surgical End Effector,” (Attorney Docket No. END7134USNP/120138).
- U.S. patent application Ser. No. ______, entitled “Surgical End Effectors Having Angled Tissue-Contacting Surfaces,” (Attorney Docket No. END7135USNP/120139).
- U.S. patent application Ser. No. ______, entitled “Interchangeable End Effector Coupling Arrangement,” (Attorney Docket No. END7136USNP/120140).
- U.S. patent application Ser. No. ______, entitled “Surgical End Effector Jaw and Electrode Configurations,” (Attorney Docket No. END7137USNP/120141).
- U.S. patent application Ser. No. ______, entitled “Multi-Axis Articulating and Rotating Surgical Tools,” (Attorney Docket No. END7138USNP/120142).
- U.S. patent application Ser. No. ______, entitled “Differential Locking Arrangements for Rotary Powered Surgical Instruments,” (Attorney Docket No. END7139USNP/120143).
- U.S. patent application Ser. No. ______, entitled “Firing System Lockout Arrangements for Surgical Instruments,” (Attorney Docket No. END7141USNP/120145).
- U.S. patent application Ser. No. ______, entitled “Rotary Drive Shaft Assemblies for Surgical Instruments with Articulatable End Effectors,” (Attorney Docket No. END7142USNP/120146).
- U.S. patent application Ser. No. ______, entitled “Rotary Drive Arrangements for Surgical Instruments,” (Attorney Docket No. END7143USNP/120147).
- U.S. patent application Ser. No. ______, entitled “Robotically Powered Surgical Device With Manually-Actuatable Reversing System,” (Attorney Docket No. END7144USNP/120148).
- U.S. patent application Ser. No. ______, entitled “Replaceable Clip Cartridge for a Clip Applier,” (Attorney Docket No. END7145USNP/120149).
- U.S. patent application Ser. No. ______, entitled “Empty Clip Cartridge Lockout,” (Attorney Docket No. END7146USNP/120150).
- U.S. patent application Ser. No. ______, entitled “Surgical Instrument System Including Replaceable End Effectors,” (Attorney Docket No. END7147USNP/120151).
- U.S. patent application Ser. No. ______, entitled “Rotary Support Joint Assemblies for Coupling a First Portion of a Surgical Instrument to a Second Portion of a Surgical Instrument,” (Attorney Docket No. END7148USNP/120152).
- U.S. patent application Ser. No. ______, entitled “Electrode Connections for Rotary Driven Surgical Tools,” (Attorney Docket No. END7149USNP/120153).
- Applicant also owns the following patent applications that are each incorporated by reference in their respective entireties:
- U.S. patent application Ser. No. 13/118,259, entitled “Surgical Instrument With Wireless Communication Between a Control Unit of a Robotic System and Remote Sensor”, U.S. Patent Application Publication No. 2011-0295270 A1;
- U.S. patent application Ser. No. 13/118,210, entitled “Robotically-Controlled Disposable Motor Driven Loading Unit”, U.S. Patent Application Publication No. 2011-0290855 A1;
- U.S. patent application Ser. No. 13/118,194, entitled “Robotically-Controlled Endoscopic Accessory Channel”, U.S. Patent Application Publication No. 2011-0295242;
- U.S. patent application Ser. No. 13/118,253, entitled “Robotically-Controlled Motorized Surgical Instrument”, U.S. Patent Application Publication No. 2011-0295269 A1;
- U.S. patent application Ser. No. 13/118,278, entitled “Robotically-Controlled Surgical Stapling Devices That Produce Formed Staples Having Different Lengths”, U.S. Patent Application Publication No. 2011-0290851 A1;
- U.S. patent application Ser. No. 13/118,190, entitled “Robotically-Controlled Motorized Cutting and Fastening Instrument”, U.S. Patent Application Publication No. 2011-0288573 A1
- U.S. patent application Ser. No. 13/118,223, entitled “Robotically-Controlled Shaft Based Rotary Drive Systems For Surgical Instruments”, U.S. Patent Application Publication No. 2011-0290854 A1;
- U.S. patent application Ser. No. 13/118,263, entitled “Robotically-Controlled Surgical Instrument Having Recording Capabilities”, U.S. Patent Application Publication No. 2011-0295295 A1;
- U.S. patent application Ser. No. 13/118,272, entitled “Robotically-Controlled Surgical Instrument With Force Feedback Capabilities”, U.S. Patent Application Publication No. 2011-0290856 A1;
- U.S. patent application Ser. No. 13/118,246, entitled “Robotically-Driven Surgical Instrument With E-Beam Driver”, U.S. Patent Application Publication No. 2011-0290853 A1; and
- U.S. patent application Ser. No. 13/118,241, entitled “Surgical Stapling Instruments With Rotatable Staple Deployment Arrangements”.
- Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these exemplary embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various exemplary embodiments of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other exemplary embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
- Uses of the phrases “in various exemplary embodiments,” “in some exemplary embodiments,” “in one embodiment”, or “in an embodiment”, or the like, throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics of one or more exemplary embodiments may be combined in any suitable manner in one or more other exemplary embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
- During various surgical procedures, a surgeon, or other clinician, may apply a clip to a patient's tissue in order to achieve various effects and/or therapeutic results. Referring to
FIG. 1 , a surgical instrument, such as aclip applier 100, for example, can be configured to apply one or more clips to tissue located within a surgical site in the patient. Generally, referring now toFIG. 13 , theclip applier 100 can be structured and arranged to position aclip 140 relative to the tissue in order to compress the tissue within theclip 140. Theclip applier 100 can be configured to deform theclip 140 as illustrated inFIGS. 3 and 4 , for example, and as described in greater detail further below. Eachclip 140 can comprise abase 142 and opposinglegs 144 extending from thebase 142. Thebase 142 and thelegs 144 can comprise any suitable shape and can define a substantially U-shaped configuration and/or a substantially V-shaped configuration, for example. The base 142 can compriseangled portions 141 which are connected together by a joint 143. In use, thelegs 144 of theclip 140 can be positioned on opposite sides of the tissue wherein thelegs 144 can be pushed toward one another to compress the tissue positioned between thelegs 144. The joint 143 can be configured to permit theangled portions 141 of thebase 142, and thelegs 144 extending therefrom, to deform inwardly. In various circumstances, theclip 140 can be configured to yield, or deform plastically, when theclip 140 is sufficiently compressed, although some amount of elastic deformation, or spring-back, may occur within thedeformed clip 140. - Referring now to
FIGS. 1 and 2 , theclip applier 100 can include ashaft 110, anend effector 120, and a replaceable clip cartridge, or magazine, 130. Referring toFIGS. 14-16 , theclip cartridge 130 can comprise ahousing 132 and a plurality ofclips 140 positioned within thehousing 132. Thehousing 132 can define astorage chamber 134 in which theclips 140 can be stacked. Thestorage chamber 134 can comprise sidewalls which extend around, or at least substantially around, the perimeter of theclips 140. Referring again toFIG. 13 , eachclip 140 can comprise opposing faces, such as atop face 145 and abottom face 146 on opposite sides of theclip 140 wherein, when theclips 140 are stacked in thehousing 132, thetop face 145 of aclip 140 can be positioned against thebottom face 146 of anadjacent clip 140 and wherein thebottom face 146 of theclip 140 can be positioned against thetop face 145 of anotheradjacent clip 140. In various circumstances, the bottom faces 146 of theclips 140 can face downwardly toward one or more support shelves, or platforms, 135 defined in thehousing 132 while the top faces 145 of theclips 140 can face upwardly away from thesupport shelves 135. The top faces 145 and the bottom faces 146 of theclips 140 may be identical, or at least substantially identical, in some cases, while, in other cases, the top faces 145 and the bottom faces 146 may be different. The stack ofclips 140 depicted inFIGS. 14-16 comprises fiveclips 140, for example; however, other embodiments are envisioned in which the stack ofclips 140 can include more than fiveclips 140 or less than fiveclips 140. In any event, theclip cartridge 130 can further comprise at least one biasing member, such as biasingmember 136, for example, positioned intermediate thehousing 132 and thetop clip 140 in the stack ofclips 140. As described in greater detail below, the biasingmember 136 can be configured to bias thebottom clip 140 in the stack ofclips 140 or, more particularly, thebottom face 146 of thebottom clip 140, against thesupport shelves 135 defined in thehousing 132. The biasingmember 136 can comprise a spring, and/or any suitable compressed elastic element, for example, which can be configured to apply a biasing force to theclips 140, or at least apply a biasing force to thetop clip 140 which is transmitted downwardly through the stack ofclips 140. - When a
clip 140 is positioned against thesupport shelves 135 as described above, theclip 140 can be supported in a firing position in which theclip 140 can be advanced and ejected from thecartridge 130. In various circumstances, thesupport shelves 135 can define at least a portion of afiring chamber 149 in which theclips 140 can be sequentially positioned in the firing position. In some cases, thefiring chamber 149 can be entirely defined within thecartridge 130 or, in other cases, thefiring chamber 149 can be defined within and/or between theshaft 110 and thecartridge 130. In any event, as described in greater detail further below, theclip applier 100 can comprise a firing drive which can advance a firing member into thecartridge 130 and push theclip 140 from its firing position positioned against thesupport shelves 135 to a fired position in which it is received within theend effector 120 of theclip applier 100. Referring primarily toFIGS. 14-16 , thehousing 132 of thecartridge 130 can comprise a proximal opening, or window, 133 which can be aligned, or at least substantially aligned, with thesupport shelves 135 such that the firing member can enter into thecartridge 130 through theproximal opening 133 and advance aclip 140 distally out of thecartridge 130. In at least one such embodiment, thehousing 132 can further comprise a distal, or discharge, opening, or window, 137 which is also aligned with thesupport shelves 135 such that theclip 140 can be advanced, or fired, distally along a firingaxis 139 extending through theproximal opening 133, thefiring chamber 149, and thedistal opening 137, for example. - In order to advance a
clip 140 out of thecartridge 130, further to the above, the firing member of the firing drive can be advanced into to thecartridge housing 132 and, in various circumstances, into thefiring chamber 149. As disclosed in greater detail further below, the firing member can pass entirely through thecartridge 130 in order to advance theclip 140 into its fired position within theend effector 120. After theclip 140 positioned in thefiring chamber 149 has been advanced distally by the firing member, as outlined above, the firing member can be retracted sufficiently such that the biasingmember 136 can position anotherclip 140 against thesupport shelves 135. In various circumstances, the biasingmember 136 can bias aclip 140 against the firing member while the firing member is positioned within thehousing 132. Such aclip 140 can be referred to as a queued clip. After the firing member has been sufficiently retracted and slid out from underneath the queuedclip 140, the biasingmember 136 can then bias theclip 140 against thesupport shelves 135 where it is staged for the next stroke of the reciprocating firing member. Referring primarily to FIGS. 2 and 14-16, thecartridge 130 can be configured to supply theclips 140 to thefiring chamber 149 along a predetermined path, such assupply axis 138, for example. Thesupply axis 138 can be transverse to the firingaxis 139 such that theclips 140 are fed into thefiring chamber 149 in a direction which is different than the direction in which the firing member passes through thefiring chamber 149. In at least one such embodiment, thesupply axis 138 can be perpendicular, or at least substantially perpendicular, to the firingaxis 139, for example. - Referring again to
FIG. 2 , theshaft 110 can comprise a cartridge, or magazine,aperture 131 which can be sized and configured to receive aclip cartridge 130, for example, therein. Thecartridge aperture 131 can be sized and configured such that thehousing 132 of thecartridge 130 is closely received within thecartridge aperture 131. The sidewalls which define thecartridge aperture 131 can limit, or at least substantially limit, the lateral movement of thecartridge 130 relative to theshaft 110. Theshaft 110 and/or thecartridge 130 can further comprise one or more locks which can be configured to releasably hold thecartridge 130 in thecartridge aperture 131. As illustrated inFIG. 2 , thecartridge 130 can be loaded into thecartridge aperture 131 along an axis which is, in at least one embodiment, parallel to or collinear with thesupply axis 138. As also illustrated inFIG. 2 , theshaft 110 can further comprise a pad orseat 118 extending from thesidewall 111 of theshaft 110 wherein thepad 118 can be configured to be received within and/or engaged with thehousing 132 of thecartridge 130. Thepad 118 can be sized and configured to be closely received within arecess 148 defined in the cartridge housing such that thepad 118 can limit, or at least substantially limit, the lateral movement of thecartridge 130 relative to theshaft 110. Thepad 118 can be sized and configured to align thecartridge 130 within theshaft 110 and/or support thecartridge housing 132. - Once the
clip cartridge 130 has been positioned and seated within theshaft aperture 131, referring now toFIGS. 5 and 6 , afiring drive 160 of theclip applier 100 can be actuated to advance theclips 140 from theclip cartridge 130 as described above. The firingdrive 160 can comprise a rotary drive input such as adrive screw 161, for example, and adisplaceable firing nut 163 operably engaged with thedrive screw 161. Thedrive screw 161 can comprise at least onedrive thread 162 which can be threadably engaged with a threaded aperture extending through the firingnut 163. In various embodiments, theclip applier 100 can further include an electric motor, for example, operably coupled with thedrive screw 161. In various instances, thedrive screw 161 can be operably coupled with the motor of a surgical instrument system comprising a hand-held instrument or a robotic arm, for example. In any event, the movement of the firingnut 163 within theshaft 110 can be constrained such that the firingnut 163 moves along alongitudinal axis 164 when thedrive screw 161 is rotated about thelongitudinal axis 164 by the motor. For instance, when thedrive screw 161 is rotated in a first direction by the motor, thedrive screw 161 can advance the firingnut 163 distally toward theend effector 120, as illustrated inFIG. 6 . When thedrive screw 161 is rotated in a direction opposite the first direction by the motor, thedrive screw 161 can retract thefiring nut 163 proximally away from theend effector 120. Theshaft 110 can comprise one or more bearings which can be configured to rotatably support thedrive screw 161. For instance, abearing 159 can be configured to rotatably support the distal end of thedrive screw 161, for example, as illustrated inFIGS. 5 and 6 . - The firing
drive 160 can further comprise a firingmember 165 extending from the firingnut 163 which can be advanced distally and retracted proximally with the firingnut 163, as described in greater detail further below. Upon comparingFIGS. 5 and 6 , the reader will note that the firingnut 163 and the firingmember 165 have been advanced from a proximal, unfired position, illustrated inFIG. 5 , to a distal, fired position, illustrated inFIG. 6 , in which the firingmember 165 has advanced aclip 140 from theclip cartridge 130 into theend effector 120. Referring primarily toFIG. 5 , theclip cartridge 130 is illustrated as comprising a plurality ofclips 140 stored therein wherein one of theclips 140 is positioned in a firing position, as described above. As illustrated inFIGS. 5 and 6 , the firingmember 165 can include adistal portion 166 which can be advanced into thestaple cartridge 130 along a firingaxis 167 and engage theclip 140 positioned in the firing position when the firingmember 165 and the firingnut 163 are advanced distally. In some cases, the firingmember 165 can comprise a linear member while, in other cases, thedistal end 166 of the firingmember 165 can extend upwardly from the firingmember 165, for example. Further to the above, the firingmember 165 can advance theclip 140 distally out of theclip cartridge 130 along the firingaxis 167 and into a receivingcavity 122 defined in theend effector 120. - In various cases, the firing
member 165 can be attached to and extend distally from the firingnut 163 while, in other cases, the firingmember 165 and the firingnut 163 can be operably connected to one another by a firingactuator 168. The firingactuator 168 can be pivotably mounted to the firingmember 165 at apivot 169 and can include adistal arm 170 a and aproximal arm 170 b which can be engaged with alongitudinal slot 113 defined in thehousing 112 of theshaft 110. In at least one such embodiment, each of thearms projections longitudinal slot 113. Further to the above, the firingnut 163 can further include afiring pin 172 extending therefrom which can be configured to engage thedistal arm 170 a in order to advance theactuator 168 and the firingmember 165 distally, as described above. In use, referring again to the progression illustrated inFIGS. 5 and 6 , the firingnut 163 can be advanced distally by thedrive screw 161 wherein thefiring pin 172, which is positioned intermediate thedistal arm 170 a and theproximal arm 170 b, can contact thedistal arm 170 a and drive theactuator 168 and the firingmember 165 distally. As theactuator 168 is advanced distally, theactuator 168 may be prevented from rotating about thepivot pin 169 as one or both of theprojections shaft slot 113 can be prevented from being moved laterally relative to thelongitudinal shaft slot 113 until theactuator 168 reaches the position illustrated inFIG. 6 . - When the
actuator 168 has reached the position illustrated inFIG. 6 , thedistal projection 171 a can enter into adistal slot portion 114 of thelongitudinal slot 113 which can be configured to pivot theactuator 168 downwardly, or permit theactuator 168 to be pivoted downwardly, as illustrated inFIG. 9 . In at least one such embodiment, thedistal projection 171 a can come into contact with the sidewall of thedistal slot portion 114 which can guide thedistal projection 171 a downwardly and pivot theactuator 168 about thepivot 169 as theactuator 168 is advanced forward by the firingnut 163. In such a pivoted position, thefiring pin 172 extending from the firingnut 163 may no longer be engaged with thedistal arm 170 a of theactuator 168 wherein, subsequently, the firingnut 163 may move distally independently of theactuator 168 thereby leaving behind theactuator 168 and the firingmember 165. Stated another way, thedistal end 114 of thelongitudinal shaft slot 113 may deactivate the firingmember 165 wherein, at such point, the position of the firingmember 165 may represent the fully-fired or distal-most position of the firingmember 165. In such a position, theclip 140 has been fully advanced into the receiving cavity, or receiver, 122. Furthermore, in such a position, thenext clip 140 to be advanced into the receivingcavity 122 may be biased against the top surface of the firingmember 165, further to the above. - Once a
clip 140 has been positioned within the receivingcavity 122, further to the above, theclip 140 can be deformed by a crimpingdrive 180, for example. Referring now toFIGS. 3 and 4 , theend effector 120 of theclip applier 100 can further comprise afirst jaw 123 a and asecond jaw 123 b wherein thefirst jaw 123 a and thesecond jaw 123 b can at least partially define the receivingchamber 122. As illustrated inFIGS. 3 and 4 , thefirst jaw 123 a can comprise afirst channel 124 a and thesecond jaw 123 b can comprise asecond channel 124 b which can each be configured to receive and support at least a portion of aclip 140 therein. Thefirst jaw 123 a can be pivotably coupled to aframe 111 of theshaft 110 by apin 125 a and thesecond jaw 123 b can be pivotably coupled to theframe 111 by apin 125 b. In use, the crimpingdrive 180 can be configured to rotate thefirst jaw 123 a toward thesecond jaw 123 b and/or rotate thesecond jaw 123 b toward thefirst jaw 123 a in order to compress theclip 140 positioned therebetween. In at least one such embodiment, the crimpingdrive 180 can comprise acam actuator 181 which can be configured to engage afirst cam surface 126 a defined on thefirst jaw 123 a and asecond cam surface 126 b on thesecond jaw 123 b in order to pivot thefirst jaw 123 a and thesecond jaw 123 b toward one another. Thecam actuator 181 can comprise a collar which at least partially surrounds thefirst jaw 123 a and thesecond jaw 123 b. In at least one such embodiment, the collar can comprise aninner cam surface 182 which can be contoured to contact the cam surfaces 126 a, 126 b of thejaws clip 140 positioned within the receivingchamber 122 defined in theend effector 120 can be positioned relative to tissue before the crimpingdrive 180 is actuated. In some circumstances, the crimpingdrive 180 can be at least partially actuated prior to positioning theclip 140 relative to the tissue in order to at least partially compress theclip 140. In certain instances, theclip 140 and the receivingchamber 122 can be sized and configured such that theclip 140 can be biased or flexed inwardly when theend effector 120 is in its unactuated state, as illustrated inFIG. 3 . In various instances, the crimpingfirst jaw 123 a and thesecond jaw 123 b can be actuated to elastically crimp and/or permanently crimp theclip 140 positioned therebetween. - Further to the above, the firing
nut 163 can be configured to actuate the crimpingdrive 180. More particularly, referring now toFIG. 7 , the crimpingdrive 180 can comprise a crimpingactuator 188 operably coupled with thecam actuator 181 wherein the crimpingactuator 188 can be selectively engaged by the firingnut 163 as the firingnut 163 is advanced distally as described above. In at least one such embodiment, the firingnut 163 can further comprise a second firing pin, such asfiring pin 184, for example, extending therefrom which can be configured to engage the crimpingactuator 188 as the firingnut 163 is advancing the firingactuator 168. Referring again toFIG. 7 , the crimpingactuator 188 is positioned in an unactuated position and, when the firingnut 163 is advanced sufficiently to engage adistal arm 190 a of the crimpingactuator 188, the firingnut 163 can rotate the crimpingactuator 188 upwardly into an actuated position as illustrated inFIG. 8 . As also illustrated inFIG. 8 , thedistal arm 190 a and aproximal arm 190 b can each comprise a projection, such asprojections shaft 110, such asslot 115, for example. As the crimpingactuator 188 is rotated upwardly from its unactuated position about apivot 189, theprojections curved end 116 of thelongitudinal slot 115 into a portion of thelongitudinal slot 115 which is substantially linear. Similar to the above, the sidewalls of thelongitudinal slot 115 can be configured to confine the movement of the crimpingactuator 188 along a longitudinal path and can be configured to limit or prevent the rotation of the crimpingactuator 188 once the crimpingactuator 188 has been rotated upwardly into an at least partially actuated position, as discussed above. As the reader will understand, thefiring pin 172 of thefiring drive 160 and thefiring pin 184 of the crimpingdrive 180 both extend from the firingnut 163. For the sake of expediency and demonstration, thefiring pins nut 163; however, it is envisioned that thefiring pin 172 can extend from a first lateral side of the firingnut 163 while thefiring pin 184 can extend from the other lateral side of the firingnut 163. In such circumstances, the firingactuator 168 can be positioned alongside the first lateral side of thedrive screw 161 and the crimpingactuator 188 can be positioned alongside the opposite lateral side of thedrive screw 161. Correspondingly, thelongitudinal slot 113 can be defined in a first lateral side of theshaft housing 112 while thelongitudinal slot 115 can be defined in the opposite lateral side of theshaft housing 112. - Further to the above, the
cam actuator 181 can be operably coupled with crimpingactuator 188 such that, when the crimpingactuator 188 is advanced distally by the firingnut 163, thecam actuator 181 can be advanced distally, as illustrated in FIGS. 8 and 10, until thedistal projection 191 a extending from thedistal arm 190 a reaches thedistal end 117 of thelongitudinal slot 115. In such a distal position, thecam actuator 181 may be in a fully advanced position and theclip 140 positioned within the receivingchamber 122 can be in a fully deformed or crimped configuration. Thereafter, thecam actuator 181 can be retracted and theend effector 120 can be reopened. More particularly, thedrive screw 161 can be rotated in an opposite direction in order to move thefiring nut 163 proximally and retract thecam actuator 181 wherein, in certain instances, theend effector 120 can further include a biasing member which can be configured to bias the first jaw 123 and thesecond jaw 123 b from the closed, or fired, position illustrated inFIG. 4 into the open, or unfired, position illustrated inFIG. 3 . As the firingnut 163 is retracted from its position illustrated inFIG. 10 , thefiring pin 184 extending from the firingnut 163 can engage theproximal arm 190 b of the crimpingactuator 188 and move the crimpingactuator 188, and thecam actuator 181 extending therefrom, proximally as illustrated inFIG. 12 . Similar to the above, theproximal projection 191 b extending from theproximal arm 190 b of the crimpingactuator 188 can be configured to contact the sidewall of the curvedproximal end 116 wherein the sidewall can guide the crimpingactuator 188 downwardly and rotate the crimpingactuator 188 about thepivot 189. At such point, thefiring pin 184 may no longer be engaged with the crimpingactuator 188, thecam actuator 181 may be fully retracted, and the firingnut 163 may continue to be retracted proximally relative to the crimpingactuator 188. - Further to the above, referring now to
FIG. 11 , the firingnut 163 can be configured to re-engage thefiring actuator 168 as the firingnut 163 is being retracted proximally. As discussed above, the firingactuator 168 is rotated downwardly when the firingactuator 168 reaches thedistal end 114 of thelongitudinal slot 113 and, as a result, the firingactuator 168 may still be in its downwardly rotated position when the firingnut 163 is retracted proximally to re-engage thefiring actuator 168. As illustrated inFIG. 11 , thefiring pin 172 extending from the firingnut 163 can engage theproximal arm 170 b of the firingactuator 168 and, as the firingnut 163 is further retracted, the firingnut 163 can rotate thefiring actuator 168 upwardly such that theprojections arms longitudinal slot 113. Thereafter, the firingnut 163 and can be retracted until the firingactuator 168 and the firingmember 165 extending therefrom have been returned to their starting, or unfired, positions illustrated inFIG. 5 . In such circumstances, the firingmember 165 can be withdrawn from theclip cartridge 130 as the firingmember 165 is retracted proximally by the firingnut 163 such that anew clip 140 can be biased into the firing chamber of theclip cartridge 130 by the biasingmember 136. Once the firingmember 165 and the firingactuator 168 have been retracted to their starting positions and thenext clip 140 has been positioned within the firing chamber, the firingdrive 160 can be actuated once again in order to move thefiring nut 163 and the firingmember 165 distally to advance thenext clip 140 into theend effector 120. Likewise, the firingnut 163 can re-actuate the crimpingdrive 180 as the firingnut 163 is moved distally once again in order to deform thenext clip 140. Thereafter, the firingnut 163 can retracted in order to re-set the crimpingdrive 180 and thefiring drive 160 once again. This process can be repeated until a sufficient number ofclips 140 have been applied to the targeted tissue and/or until theclips 140 contained within theclip cartridge 130 have been depleted. In the event thatadditional clips 140 are needed, the expendedclip cartridge 130 can be removed from theshaft 110 and areplacement clip cartridge 130 containingadditional clips 140 can be inserted into theshaft 110. In some circumstances, an at least partially depletedclip cartridge 130 can be replaced with an identical, or at least nearly identical,replacement clip cartridge 130 while, in other circumstances, theclip cartridge 130 can be replaced with a clip cartridge having more than or less than fiveclips 140 contained therein and/or a clip cartridge having clips other thanclips 140 contained therein, for example. - Referring again to
FIGS. 6-9 , the firingnut 163 of the illustrated embodiment can be configured to become disengaged from the firingactuator 168 at the same time that the firingnut 163 becomes engaged with the crimpingactuator 188. Stated another way, the firingdrive 160 can be deactivated at the same time that the crimpingdrive 180 is activated. In various circumstances, such timing can be achieved when thedistal end 114 of thelongitudinal slot 113 is aligned, or at least substantially aligned, with theproximal end 116 of the secondlongitudinal slot 115, for example. In the illustrated embodiment and/or any other suitable embodiment, a lag can exist between the deactivation of thefiring drive 160 and the activation of the crimpingdrive 180. Such a lag between the end of the firing stroke of the firingmember 165 and the beginning of the firing stroke of thecam actuator 181 can be created, in some circumstances, to assure that theclip 140 has been positioned in its fully-seated position within the receivingchamber 122 before theclip 140 is deformed by thecam actuator 181. In various circumstances, such a lag can be created when thedistal end 114 of thelongitudinal slot 113 is positioned proximally with respect to theproximal end 116 of the secondlongitudinal slot 115, for example. In the illustrated embodiment and/or any other suitable embodiment, the deactivation of thefiring drive 160 may occur after the activation of the crimpingdrive 180. Such an overlap between the end of the firing stroke of the firingmember 165 and the beginning of the firing stroke of thecam actuator 181 can be created, in some circumstances, to apply at least some inward pressure on theclip 140 as it is moved into its fully-seated position within the receivingchamber 122 so as to reduce or eliminate relative movement between theclip 140 and the sidewalls of the receivingchamber 122, for example. In various circumstances, such an overlap can be created when thedistal end 114 of thelongitudinal slot 113 is positioned distally with respect to theproximal end 116 of the secondlongitudinal slot 115, for example. - In the illustrated embodiment of
FIG. 1 and/or any other suitable embodiment, turning now toFIG. 17 , a clip cartridge, such asclip cartridge 230, for example, can comprise apusher plate 248 positioned intermediate the biasingmember 136 and thetop-most clip 140 stacked within theclip cartridge 230. Thepusher plate 248 can be rigid, or at least substantially rigid, and can comprise a first bearing surface against which the biasingmember 136 can apply a biasing force. Thepusher plate 248 can also comprise a second bearing surface which can transmit the biasing force to thetop surface 145 of thetop-most clip 140. Thepusher plate 248 can be comprised of a sheet of stainless steel material, for example, although thepusher plate 248 can comprise any suitable shape and can be comprised of any suitable material. In certain instances, thepusher plate 248 may not be attached to the biasingmember 136 while, in other instances, thepusher plate 248 can be affixed to the biasingmember 136 such that thepusher plate 248 does not become dislodged from thecartridge housing 132. In various circumstances, thepusher plate 248 can be sized and configured such that it cannot pass through theproximal opening 133 and/or thedistal opening 137 defined in thecartridge housing 132. - In the illustrated embodiment of
FIG. 1 and/or any other suitable embodiment, turning now toFIGS. 18 and 19 , a clip cartridge, such asclip cartridge 330, for example, can comprise a lockout member which can be positioned within thefiring chamber 149 of theclip cartridge 330 after all of theclips 140 contained within theclip cartridge 330 have been ejected from thecartridge 330. The lockout member can comprise alockout plate 348 which can be positioned intermediate the biasingmember 136 and thetop surface 145 of thetop-most clip 140 contained within theclip cartridge 330. In use, further to the above, theclips 140 can be sequentially positioned in thefiring chamber 149 of theclip cartridge 130 and then advanced distally out of theclip housing 132 wherein, after thelast clip 140 has been advanced out of theclip housing 132 and the firingmember 165 has been withdrawn from theclip cartridge 130, the biasingmember 136 can bias thelockout plate 348 against theshelves 135. In such a position, thelockout plate 348 can be aligned with theproximal opening 133 and thedistal opening 137 such that the firingmember 165 cannot enter, or at least substantially enter, theclip cartridge 130. In such circumstances, thelockout plate 348 can block the firingmember 165 from entering into and passing through thehousing 132 and, as a result, prevent the inadvertent firing of theclip applier 100 after theclip cartridge 130 has run out of clips. In the event that the operator of theclip applier 100 were to actuate thefiring drive 160 and attempt to advance the firingmember 165 into the spentclip cartridge 130, the firingmember 165 would contact and abut thelockout plate 348 wherein, in such circumstances, a compressive load can be created within the firingmember 165. Theclip applier 100 can further include a clutch which can be configured to slip and operably disconnect the motor from thedrive screw 161 when the compressive load created within the firingmember 165 exceeds a certain or predetermined amount. In addition to or in lieu of a clutch, the motor and/or motor controller of theclip applier 100 which operates thefiring drive 160, for example, can comprise a load sensor configured to detect the load generated within the firingmember 165 and, when the load created within the firingmember 165 exceeds a certain or predetermined amount, the voltage and/or current supplied to the motor can be switched off and/or reduced. In any event, thelockout plate 348 can be sized and configured such that thelockout plate 348 cannot be dislodged through thedistal opening 137 and/or theproximal opening 133 when the firingmember 165 contacts thelockout plate 348. In order to use theclip applier 100 once again, the operator of theclip applier 100 can remove the spentcartridge 330 from theshaft 110 and insert anew clip cartridge 330, for example, into theshaft 110. At such point, aclip 140 may be positioned within thefiring chamber 149 of thenew clip cartridge 330 and the firingmember 165 can be advanced distally into thenew clip cartridge 330 to deploy theclip 140 as described above. - In the illustrated embodiment of
FIG. 1 and/or any other suitable embodiment, referring now toFIGS. 20 and 21 , a clip cartridge, such asclip cartridge 430, for example, can comprise guides which can be configured to limit or confine the movement of a lockout member within theclip cartridge 430. Similar to the above, the lockout member can comprise alockout plate 448, for example, which can be positioned intermediate the biasingmember 136 and thetop surface 145 of thetop-most clip 140 contained within thehousing 432 of theclip cartridge 430. In use, similar to the above, thelockout plate 448 can be progressively pushed downwardly into thefiring chamber 149 as theclips 140 are sequentially ejected from theclip cartridge 430. Thelockout plate 448 can be sized and configured such that it is closely received within thecartridge housing 432 and such that relative lateral movement between thelockout plate 448 and thehousing 432 can be limited in order to reduce, or prevent, the possibility of thelockout plate 448 becoming misaligned within theclip cartridge 430. In the event that thelockout plate 448 were to become misaligned within theclip cartridge 430, thelockout plate 448 may bind within thehousing 432 and prevent the biasingmember 136 from applying an appropriate biasing force to the stack ofclips 140, for example. As illustrated inFIGS. 20 and 21 , the lockout plate 438 can further compriseguide members 447 extending therefrom which can be received withinguide slots 446 defined in thecartridge housing 432. Theguide members 447 and theguide slots 446 can be sized and configured such that theguide members 447 are closely received within theguide slots 446 and such that relative lateral movement between the lockout plate 438 and thecartridge housing 432 can be limited. Each of theguide slots 446 can be defined by opposingsidewalls 445 which can define a distance therebetween which is equal to or slightly larger than the width of theguide member 447 positioned therein such that theguide member 447 can slide between the opposingsidewalls 445 between the top 443 and thebottom 444 of theguide slot 446. Thus, while theguide members 447 and theguide slots 446 can be configured to limit lateral movement therebetween, as outlined above, theguide members 447 and theguide slots 446 can be configured to permit relative movement between the lockout plate 438 and thecartridge housing 432 along a predetermined path parallel to or collinear with thesupply axis 138, for example. When the lockout plate 438 is pushed into thefiring chamber 149 by the biasingmember 136, the lockout plate 438 can inhibit the advancement of the firingmember 165 and the operation of theclip applier 100, as outlined above, until the spentclip cartridge 430 is replaced with another suitable clip cartridge. - In the illustrated embodiment of
FIG. 1 and/or any other suitable embodiment, as discussed above, thedrive screw 161 can be rotated in a first direction to advance the firingnut 163 distally and rotated in a second, or reverse, direction to retract thefiring nut 163 proximally. In order to rotate thedrive screw 161 in the first and second directions, the electric motor operably coupled with thedrive screw 161 can be operated in corresponding first and second directions. In the illustrated embodiment ofFIG. 1 and/or any other suitable embodiment, a clip applier can utilize a motor which is operated in only a first direction wherein the rotation of the motor in such a single direction can be utilized to advance a firing nut distally and retract the firing nut proximally. Turning now toFIGS. 22-26 , the output of an electric motor can be transmitted to adrive system 560 via atransmission system 550. Thetransmission system 550 can comprise aninput shaft 552 which is operated in a single direction wherein thetransmission system 550 can be switchable or shiftable between a first state, or configuration, in which thetransmission system 550 rotates adrive screw 561 of thedrive system 560 in a first direction and a second state, of configuration, in which thetransmission system 550 rotates thedrive screw 561 in a second, or opposite, direction. The first state of thetransmission system 550 is depicted inFIGS. 22-24 and the second state of thetransmission system 550 is depicted inFIGS. 25 and 26 . - Referring again to
FIGS. 22-24 , theinput shaft 552 can comprise aninput gear 551 mounted thereto which is operably coupled, or meshingly engaged, with ashifter gear 553 such that the rotation of theinput shaft 552 is transmitted to theshifter gear 553. With regard to all of the gears discussed herein, gears which are operably coupled or meshingly engaged with one another can comprise any suitable arrangement of teeth, for example, which can transmit the rotation of one gear to the other. When theinput shaft 552 is rotated in the first direction, theshifter gear 553 is rotated in the second, or opposite, direction. In the first state of the transmission system, theshifter gear 553 is in a first position in which theshifter gear 553 is operably coupled with anintermediate gear 554 wherein, when theshifter gear 553 is rotated in the second direction by theinput gear 551, as discussed above, theintermediate gear 554 is rotated in the first direction. Although not illustrated, theintermediate gear 554 can be rotatably supported within theshaft 110 of theclip applier 100, for example. Theintermediate gear 554 can also be operably coupled with anoutput gear 555 mounted to thedrive screw 561 such that the rotation of theintermediate gear 554 can be transmitted to theoutput gear 555. When theintermediate gear 554 is driven in the first direction by theshifter gear 553, as described above, theintermediate gear 554 can drive theoutput gear 555 and thedrive screw 561 in the second direction. Similar to the above, the firingnut 563 can be operably coupled with thedrive screw 561 and suitably constrained within theshaft 110 such that, when thedrive screw 561 is rotated in the second direction, the firingnut 563 is advanced distally as indicated by the arrow D. - Similar to the above, the firing
nut 563 can be advanced to its distal-most position, illustrated inFIG. 24 , in order to advance aclip 140 from theclip cartridge 130 into theend effector 120 and crimp theclip 140 as described above. As illustrated inFIGS. 23 and 24 , the firingnut 563 can further comprise acam bar 569 extending therefrom which can be configured to shift thetransmission system 550 from its first state to its second state. Upon comparingFIG. 24 andFIG. 25 , the reader will note that theshifter gear 553 is movable between a first position in which thetransmission system 550 is in its first state and a second position in which thetransmission system 550 is in its second state. More particularly, theshifter gear 553 is mounted to ashifter 556 which is rotatable about theinput shaft 552 such that theshifter gear 553 can be rotated from its first position in which theshifter gear 553 is operably engaged with theinput gear 551 and theintermediate gear 554 and its second position in which theshifter gear 553 is operably disengaged from theintermediate gear 554. Although theshifter gear 553 is operably disengaged from theintermediate gear 554 when theshifter gear 553 is in its second position, theshifter gear 553 can be operably coupled with theinput gear 551 and theoutput gear 555 in order to transmit rotary motion from theinput shaft 552 to thedrive screw 561. As illustrated inFIGS. 24 and 25 , theshifter 556 can comprise a central aperture through which theinput shaft 552 can extend; however, theshifter 556 may not be operably engaged with theinput shaft 552 and, as a result, the rotation of theinput shaft 552 may not rotate theshifter 556 and, likewise, the rotation of theshifter 556 may not rotate theinput shaft 552. In any event, theshifter 556 can further comprise acam follower 558 extending therefrom which can be engaged by acam 568 defined on thecam bar 569 as the firingnut 563 is advanced distally. When thecam 568 engages thecam follower 558, thecam 568 can rotate theshifter 556 and theshifter gear 553 between its first position and its second position as described above. - When the
shifter gear 553 is in its second position and thetransmission system 550 is in its second state, as described above, theinput shaft 552 and thedrive screw 561 can both be rotated in the first direction. More particularly, theinput shaft 552, when rotated in the first direction, can rotate theinput gear 551 in the first direction and, as theshifter gear 553 is directly engaged with theinput gear 551, theshifter gear 553 will be rotated in the second direction. The reader will note that theshifter gear 553 rotates in the second direction when thetransmission system 550 is in its second state as compared to the first, or opposite, direction when thetransmission system 550 is in its first state. Upon comparingFIGS. 24 and 25 , further to the above, the reader will appreciate that theintermediate gear 554 is no longer operably positioned intermediate theinput gear 551 and theshifter gear 553 when thetransmission system 550 is in its second state thereby accounting for the different directions of rotation. As theshifter gear 553 is operably engaged with theinput gear 551 and theoutput gear 555 when theshifter gear 553 is in its second position, theshifter gear 553 can rotate theoutput gear 555, and thedrive screw 561 coupled to theoutput gear 555, in the first direction. When thedrive screw 561 is rotated in the first direction, as illustrated inFIGS. 25 and 26 , the firingnut 563 can be retracted proximally to permit theend effector 120 to be reopened and to retract the firingmember 165. Referring primarily toFIG. 26 , the firingnut 563 can further comprise asecond cam bar 567 extending therefrom comprising acam 566 which can be configured to contact thecam follower 558 of theshifter 556 as the firingnut 563 is retracted proximally into its fully-retracted position. In such circumstances, thecam 566 can push theshifter 556 back into its first position and into operative engagement with theintermediate gear 554 such that thetransmission system 550 can be reset into its first state and theclip applier 100 can be actuated once again. - As discussed above, the firing drive of the
clip applier 100 can be operated by a surgical instrument system comprising an electric motor. A roboticsurgical instrument system 20 is illustrated inFIG. 27 and can comprise a plurality ofmovable arms 30. Eacharm 30 can comprise anactuator module 32 comprising an electric motor configured to supply the rotary motion to theshaft 110 of aclip applier 100, and/or any other suitable surgical instrument. Referring now toFIG. 28 , anend effector 620 may be selectively engageable with and disengageable from anactuator shaft 610 of a clip applier wherein theend effector 620 can comprise aproximal end 621 which can be coupled to adistal end 611 of theshaft 610. Theproximal end 621 of theend effector 620 can comprise anouter housing 629, a frame extending through theouter housing 629, an outer drive shaft extending through the frame, and an inner drive shaft extending through the outer drive shaft. Similarly, thedistal end 611 of theshaft 610 can comprise anouter housing 619, aframe 663 extending through theouter housing 619, anouter drive shaft 662 extending through theframe 663, and aninner drive shaft 661 extending through theouter drive shaft 662. With regard to thedistal end 611 of theshaft 610, theframe 663, theouter drive shaft 662, and theinner drive shaft 661 can each comprise a portion of atongue connector 613 extending therefrom and a portion of aconnector groove 612 defined therein, wherein thetongue connector 613 can be configured to be received within atongue groove 623 defined in theproximal end 621 of theend effector 620, and wherein thetongue groove 612 can be configured to receive atongue connector 622 extending from theproximal end 621 of theend effector 620. Similar to thetongue connector 613 which extends across theframe 663, theouter drive shaft 662, and theinner drive shaft 661 of thedistal shaft end 611, thetongue connector 622 can extend across the frame, the outer drive shaft, and the inner drive shaft of theproximal end 621 of theend effector 620. Also, similar to thetongue groove 612 which extends across theframe 663, theouter drive shaft 662, and theinner drive shaft 661 of thedistal shaft end 611, thetongue groove 623 can extend across the frame, the outer drive shaft, and the inner drive shaft of theproximal end 621 of theend effector 620. In the configuration depicted inFIG. 28 , thetongue connector 622 of theend effector 620 can be slid laterally into thetongue groove 612 of theshaft 610 at the same time that thetongue connector 613 of theshaft 610 is slid laterally into thetongue groove 623 of theend effector 620. Owing to such assembly, the frame of theend effector 620 can be securely coupled to theframe 663 of theshaft 610, the outer drive shaft of theend effector 620 can be operably coupled to theouter drive shaft 662 of theshaft 110, and the inner drive shaft of theend effector 620 can be operable coupled to theinner drive shaft 661 of theshaft 110. The reader will note that the portions of thetongue connector 612 are aligned with one another, the portions of thetongue groove 613 are aligned with one another, the portions of thetongue groove 622 are aligned with one another, and the portions of thetongue connector 623 are aligned with one another when theend effector 620 is assembled to theshaft 610. Once assembled, theouter drive shaft 662 of theshaft 110 can rotate the outer drive shaft of theend effector 620, and theinner drive shaft 661 of theshaft 610 can rotate the inner drive shaft of theend effector 620. When theouter drive shaft 662 and/or theinner drive shaft 661 are rotated, the portions of thetongue connector 612, the portions of thetongue groove 613, the portions of thetongue groove 622, and the portions of thetongue connector 623 may no longer be aligned. In order to remove theend effector 620 from theshaft 610, theinner drive shaft 661 and/or theouter drive shaft 662 can be rotated into one or more positions in which thetongue connectors tongue grooves - Referring again to
FIG. 28 , theouter housing 619 of theshaft 610 can further comprise astop 614 which can be configured to limit the lateral movement of theend effector 620 as theend effector 620 is being slid transversely onto thedistal end 611 of theshaft 610. Thestop 614 can provide a datum from which the inner drive shaft of theend effector 620 and theinner drive shaft 661 of theshaft 610 are aligned alonglongitudinal axis 615, the outer drive shaft of theend effector 620 and theother drive shaft 662 of theshaft 610 are aligned alonglongitudinal axis 615, and/or the frame of theend effector 620 and theframe 663 of theshaft 610 are aligned along thelongitudinal axis 615. Further to the above, theinner drive shaft 661 can extend into anactuator module 632 which can comprise an electric motor and/orgear train 664 operably coupled with theinner drive shaft 661 configured to rotate theinner drive shaft 661. Furthermore, theactuator module 632 can comprise a second electric motor and gear train operably engaged with thesecond drive shaft 662 configured to drive thesecond drive shaft 662. As described in greater detail below, a second electric motor can be utilized to articulate theend effector 620. Also, further to the above, theouter housing 619 and/or theframe 663 of theshaft 610 can further comprise agear 617 mounted thereto which is operably engaged with an electric motor andgear train 618 which can be configured to rotate theshaft 610 and theend effector 620 about thelongitudinal axis 615. For instance, if the electric motor andgear train 618 are operated in a first direction, theshaft 610 and theend effector 620 can be rotated about theaxis 615 in a clockwise direction while, if the electric motor andgear train 618 are operated in a second direction, theshaft 610 and theend effector 620 can be rotated about theaxis 615 in a counter-clockwise direction in order to position and orient theend effector 620. - As discussed above, the
end effector 620 can be selectively attached to and detached from theshaft 610. The reader will note that the principles discussed in connection with theend effector 620 andshaft 610 can be equally applied to theend effector 120 and theshaft 110 of the embodiment disclosed inFIG. 1 , among others. That said, referring again toFIG. 27 , one of therobotic arms 30 can be selectively engaged with anend effector 120 of a clip applier or, alternatively, any other suitable end effector, such as the end effector of a surgical stapler, for example. In such circumstances, anend effector 120 can be selectively interchanged with another end effector and, as a result, a singlerobotic arm 30 can be utilized to perform more than one function. Stated another way, theclip applier 100 can comprise a replaceable loading unit which can be replaced by, or interchanged with, another clip applier loading unit and/or any other suitable replaceable loading unit. Turning now toFIG. 29 , theend effector 120 and theshaft 110 of theclip applier 100 can be utilized with a surgical instrument system comprising ahandle 700. Thehandle 700 can comprise anactuator 701 which can be operated, or squeezed towardgrip 702, in order to apply a rotary motion to thedrive screw 161 as described above. In some cases, the rotation of theactuator 701 can be mechanically transmitted to thedrive screw 161 while, in other cases, theactuator 701 can operate a motor operably coupled to thedrive screw 161. - Further to the above, the
end effector 120 and theshaft 110 of theclip applier 100 can be aligned along a longitudinal axis of theclip applier 100. Turning now toFIG. 30 , theend effector 120 and/or theshaft 110 can further comprise an articulation joint 101 which can be configured to permit theend effector 120 to be articulated relative to the longitudinal axis of theclip applier 100. Theshaft 110 can comprise an outer housing, or frame portion, 119 which can comprise aproximal end 102 and can comprise a distal portion of the articulation joint 101. Theproximal end 102 can comprise a spherical, or an at least substantially spherical,end 102, for example, which can be received within a spherical, or an at least substantially spherical,cavity 104 defined in an articulationjoint member 103. The articulationjoint member 103 can also comprise a spherical, or at least substantially spherical,end 105, for example, which can be received within a spherical, or an at least substantially spherical,cavity 107 defined in ashaft frame portion 106. Theproximal end 102 of theshaft 110 can be at least partially captured within thecavity 104 such that theproximal end 102 cannot be readily removed from thecavity 104. That said, theproximal end 102 and thecavity 104 can be sized and configured to permit theproximal end 102 to be rotated in any suitable direction within thecavity 104. As also illustrated inFIG. 30 , theclip applier 100 can further comprise articulation controls 108 a and 108 b, for example, which can extend through the articulation joint 101 and can comprise distal ends mounted within mountingapertures proximal end 102 of theshaft housing 119. In use, the articulation controls 108 a and 108 b can be pushed and/or pulled in order to move theproximal end 102 within thecavity 104. Further to the above, theend 105 of the articulationjoint member 103 can be at least partially captured within thecavity 107 defined in theshaft frame portion 106 such that theend 105 cannot be readily removed from thecavity 107. That said, theend 105 and thecavity 107 can be sized and configured to permit theend 105 to be rotated in any suitable direction within thecavity 107 when theshaft end 102 is pushed and/or pulled by theactuators - Further to the above, referring again to
FIG. 30 , thedrive screw 161 can be rotated by an input shaft, such asinput shaft 152, for example. Theinput shaft 152 can extend through anaperture 156 defined within theshaft frame portion 106, the articulationjoint member 103, and theproximal end 102 of theshaft housing 119. Theinput shaft 152 can comprise aninput gear 151 mounted to the distal end thereof which can be operably coupled with anoutput gear 155 mounted to the proximal end of thedrive screw 161. In use, theinput shaft 152 can be rotated by the electric motor, described above, wherein theinput shaft 152 can rotate thedrive screw 161. As outlined above, the articulation joint 101 can be configured to permit theend effector 120 and at least a portion of theshaft 110 to be articulated relative to a longitudinal axis defined by theclip applier 100. In order to accommodate such movement, at least the portion of theinput shaft 152 extending through the articulation joint 101 can be sufficiently flexible. - Turning now to
FIGS. 31-35 , the articulation actuators 108 a and 108 b can be operated by an actuator module such asmodule 832, for example. Referring primarily toFIG. 31 , theactuator module 832 can comprise arotatable articulation driver 833 which can be configured to push and pull the articulation actuators 108 a and 108 b. Thearticulation driver 833 can comprise a cylindrical, or an at least substantially cylindrical,collar 835 including anaperture 837 which can be configured to receive at least a portion of theshaft frame 106 therein in order to rotatably support thecollar 835. Thearticulation driver 833 can further comprise aninput gear portion 834 which can be operably coupled with an electric motor andgear train 831 of themodule 832 wherein, when the electric motor andgear train 831 are actuated, thearticulation driver 833 can be rotated about theshaft frame 106. Referring primarily toFIGS. 32 and 34 , thearticulation driver 833 can further comprise two cam slots defined in the sidewall of thecollar aperture 837, although the reader will note that only onecam slot 835 a is illustrated in the provided views. Thecam slot 835 a is configured to receive acam follower 838 a extending from thearticulation driver 108 a wherein thecam follower 838 a is configured to slide within thecam slot 835 a. When thearticulation driver 833 is rotated, the helical contour of thecam slot 835 a, for example, can be configured to push thecam follower 838 a distally or pull the cam follower 838 proximally, depending on the direction in which thearticulation driver 833 is rotated. As a result of the proximal or distal movement of the cam follower 838, thecam actuator 108 a can be moved proximally or distally, respectively. While not illustrated, thearticulation driver 108 b can comprise a cam follower, similar to thecam follower 838 a, which can be configured to slide within the other cam slot discussed above. The other cam slot can be configured such that, when thearticulation actuator 108 a is driven distally by thearticulation driver 833 when thearticulation driver 833 is rotated in a first direction, thearticulation actuator 108 b can be pulled proximally. Similarly, the other cam slot can be configured such that, when thearticulation actuator 108 a is pulled proximally by thearticulation driver 833 when thearticulation driver 833 is rotated in a second direction, thearticulation actuator 108 b can be driven distally. Referring primarily toFIG. 32 , theshaft frame portion 106 can compriseclearance slots 839 defined therein through which the cam actuators 838 can extend. Although the above features have been discussed in connection with anactuator module 832, such features could be used in connection with the other actuator modules disclosed herein. - A clip applier loading unit can comprise a shaft including a distal end, a proximal end, and a frame comprising a frame connector configured to be releasably attached to a frame of an actuator. The clip applier loading unit can further comprise a plurality of clips and an end effector extending from the distal end of the shaft, wherein the end effector comprises a first jaw, a movable second jaw, and a receiver defined between the first jaw and the second jaw. The receiver is configured to receive a clip, wherein the second jaw is movable toward the first jaw to deform the clip positioned in the receiver. The clip applier loading unit can further comprise a firing drive comprising a distal portion configured to advance a clip into the receiver and a proximal portion comprising a drive connector configured to be releasably attached to a driver of the actuator.
- A clip applier loading unit can comprise a shaft comprising a distal end, a proximal end, a frame comprising a frame connector configured to be releasably attachable to and detachable from a frame of an actuator unit, and a bearing. The clip applier loading unit can further comprise a plurality of clips and an end effector extending from the distal end of the shaft, wherein the end effector comprises a first jaw, a second jaw movable relative to the first jaw, and a receiver defined between the first jaw and the second jaw, wherein the receiver is configured to receive a clip. The clip applier loading unit can further comprise a reciprocating rotary firing drive comprising a rotatable driver comprising a thread, wherein the rotatable driver is rotatably supported by the bearing, and, in addition, a firing nut threadably engaged with the thread of the rotatable driver, wherein the firing nut is advanceable toward the distal end when the driver is rotated in a first direction, wherein the firing nut is retractable away from the distal end when the driver is rotated in a second direction opposite the first direction, and wherein the firing nut is configured to advance a clip into the receiver when the firing nut is advanced toward the distal end.
- A clip applier loading unit comprising a shaft including a distal end, a proximal end, a frame, and connection means for releasably attaching the frame to an actuator. The clip applier can further comprise a plurality of clips and an end effector extending from the distal end of the shaft, wherein the end effector comprises a first jaw, a movable second jaw, and a receiver defined between the first jaw and the second jaw, wherein the receiver is configured to receive a clip, and wherein the second jaw is movable toward the first jaw to deform a clip positioned in the receiver. The clip applier loading unit can further comprise firing means for advancing a clip into the receiver.
- A clip applier for clipping tissue can comprise a shaft including a distal portion, a distal opening defined in the distal portion, and a magazine opening. The clip applier can further comprise a magazine assembly removably positionable in the magazine opening, wherein the magazine assembly comprises a housing, a storage chamber defined in the housing, a firing platform, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to bias the clips toward the firing platform. The clip applier can further comprise a firing drive configured to advance a clip from the magazine through the distal opening.
- A magazine assembly for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a firing platform, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to bias the clips toward the firing platform.
- A clip applier surgical instrument can comprise a shaft including a distal portion and a cartridge receptacle, and a cartridge assembly removably positionable in the cartridge receptacle. The cartridge assembly can comprise a housing, a storage chamber defined in the housing, a discharge opening, a stack of clips removably positioned within the storage chamber, wherein the stack of clips comprises a plurality of clips stacked on top of one another, and a biasing member configured to align a clip with the discharge opening. The clip applier surgical instrument can further comprise a firing drive configured to advance a clip from the magazine through the discharge opening.
- A cartridge assembly for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a discharge opening, a stack of clips removably positioned within the storage chamber, wherein the stack of clips comprises a plurality of clips stacked on top of one another, and a biasing member configured to align a clip with the discharge opening.
- A surgical device for applying clips can comprise a shaft including a distal portion, a loading port defined in the distal portion, and a discharge opening. The surgical device can further comprise a clip cartridge removably positionable in the loading port, wherein the clip cartridge comprises a stack of clips, a biasing member configured to align a clip with the discharge opening, and a firing drive configured to advance a clip from the clip cartridge through the discharge opening.
- A clip cartridge removably for use with a clip applier can be positionable in a loading port of the clip applier, wherein the clip cartridge can comprise a stack of clips and a biasing member configured to align a clip with a discharge opening.
- A surgical device for applying clips can comprise a shaft, supply means for supplying a plurality of clips along a supply axis, and firing means for advancing a clip from a pre-fired position to a fired position along a firing axis, wherein the supply axis is transverse to the firing axis.
- A clip applier for clipping tissue comprising a shaft, a firing chamber, an end effector extending from the shaft, wherein the end effector comprises a crimping chamber, and a magazine assembly comprising a housing, a storage chamber defined in the housing, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber. The clip applier can further comprise a reciprocating firing drive configured to advance a clip positioned in the firing chamber into the crimping chamber, and a lockout plate positioned intermediate the biasing member and the plurality of clips, wherein the biasing member is configured to bias the lockout plate into the firing chamber after all of the plurality of the clips have been advanced into the crimping chamber, and wherein the lockout plate is configured to block the firing drive.
- A magazine assembly for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a plurality of clips removably positioned within the storage chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber. The magazine assembly can further comprise a lockout plate positioned intermediate the biasing member and the plurality of clips, wherein the biasing member is configured to bias the lockout plate into the firing chamber after all of the plurality of the clips have been advanced from the housing, and wherein the lockout plate is configured to block a firing drive from entering the firing chamber.
- A surgical device for applying clips can comprise a shaft, an end effector comprising a receiver, and a cartridge comprising a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing platform, and a biasing member configured to sequentially bias the clips from the storage chamber onto the firing platform. The surgical device can further comprise a reciprocating firing drive configured to advance a clip positioned on the firing platform into the receiver, and a lockout member positioned intermediate the biasing member and the stack of clips, wherein the biasing member is configured to bias the lockout member against the firing platform after all of the clips have been advanced into the receiver, and wherein the lockout member is configured to block the firing drive.
- A cartridge for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing platform, and a biasing member configured to sequentially bias the clips from the storage chamber onto the firing platform. The cartridge can further comprise a lockout member positioned intermediate the biasing member and the stack of clips, wherein the biasing member is configured to bias the lockout member against the firing platform after all of the clips have been advanced out of the housing, and wherein the lockout member is configured to block a firing drive from passing through the housing.
- A surgical device for clipping tissue can comprise a shaft, an end effector comprising a receiver, and a cartridge comprising a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber. The surgical device can further comprise a reciprocating firing drive configured to advance a clip positioned in the firing chamber into the receiver during a firing stroke, and blocking means for inhibiting the firing drive from completing a firing stroke after all of the clips have been advanced into the receiver.
- A cartridge for use with a clip applier can comprise a housing, a storage chamber defined in the housing, a stack of clips removably positioned within the storage chamber, a firing chamber, and a biasing member configured to sequentially bias the clips from the storage chamber into the firing chamber. The cartridge can further comprise blocking means for inhibiting a firing drive from completing a firing stroke after all of the clips have been advanced from the housing.
- The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
- Although the present invention has been described herein in connection with certain disclosed exemplary embodiments, many modifications and variations to those exemplary embodiments may be implemented. For example, different types of end effectors may be employed. Also, where materials are disclosed for certain components, other materials may be used. The foregoing description and following claims are intended to cover all such modification and variations.
- The entire disclosures of U.S. Pat. No. 8,075,571, entitled SURGICAL CLIP APPLIER METHODS, which issued on Dec. 13, 2011; U.S. Pat. No. 8,038,686, entitled CLIP APPLIER CONFIGURED TO PREVENT CLIP FALLOUT, which issued on Oct. 18, 2011; and U.S. Pat. No. 7,699,860, entitled SURGICAL CLIP, which issued on Apr. 20, 2010, are hereby incorporated by reference herein.
- Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
Claims (21)
Priority Applications (8)
Application Number | Priority Date | Filing Date | Title |
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US13/536,374 US9561038B2 (en) | 2012-06-28 | 2012-06-28 | Interchangeable clip applier |
EP13734252.3A EP2866685B1 (en) | 2012-06-28 | 2013-06-20 | Interchangeable clip applier |
PCT/US2013/046799 WO2014004257A1 (en) | 2012-06-28 | 2013-06-20 | Interchangeable clip applier |
CN201380034186.6A CN104487006B (en) | 2012-06-28 | 2013-06-20 | interchangeable applicator |
RU2015102667A RU2636175C2 (en) | 2012-06-28 | 2013-06-20 | Interchangeable clip applier |
IN10782DEN2014 IN2014DN10782A (en) | 2012-06-28 | 2013-06-20 | |
BR112014032857-9A BR112014032857B1 (en) | 2012-06-28 | 2013-06-20 | CLIP APPLICATOR LOADING UNIT |
JP2015520318A JP6258311B2 (en) | 2012-06-28 | 2013-06-20 | Replaceable clip applier |
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US13/536,374 US9561038B2 (en) | 2012-06-28 | 2012-06-28 | Interchangeable clip applier |
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US9561038B2 US9561038B2 (en) | 2017-02-07 |
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EP (1) | EP2866685B1 (en) |
JP (1) | JP6258311B2 (en) |
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CN104487006A (en) | 2015-04-01 |
US9561038B2 (en) | 2017-02-07 |
RU2015102667A (en) | 2016-08-20 |
CN104487006B (en) | 2017-08-11 |
EP2866685A1 (en) | 2015-05-06 |
IN2014DN10782A (en) | 2015-09-04 |
RU2636175C2 (en) | 2017-11-21 |
BR112014032857A2 (en) | 2017-06-27 |
JP2015521905A (en) | 2015-08-03 |
WO2014004257A1 (en) | 2014-01-03 |
JP6258311B2 (en) | 2018-01-10 |
EP2866685B1 (en) | 2019-01-09 |
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